Antipsychotic Exposure in Clinical High Risk of Psychosis

作者：JiaHui Zeng, Andrea Raballo, RanPiao Gan, GuiSen Wu, YanYan Wei, LiHua Xu, XiaoChen Tang, YeGang Hu, YingYing Tang, Tao Chen, ChunBo Li, JiJun Wang, TianHong Zhang · 发表于：The Journal of Clinical Psychiatry · 年份：2022 · DOI：10.4088/jcp.21m14092 · 被引用次数：21 · 研究领域：Schizophrenia research and treatment、Tryptophan and brain disorders、Healthcare Decision-Making and Restraints

Objective: Current treatment guidelines for individuals at clinical high risk (CHR) for psychosis do not recommend the prescription of antipsychotics (not even second-generation ones) as the first treatment option for preventing psychosis. Yet, recent meta-analytic evidence indicates that antipsychotic exposure in CHR is relatively widespread and associated with a higher imminent risk of transition to psychosis. Therefore, we undertook this study to better delineate which clinical characteristics of CHR individuals may lead to the choice of antipsychotic prescription and whether it identifies a subgroup at higher risk for conversion to psychosis. Methods: Consecutively referred CHR individuals (N = 717) were assessed for demographic and clinical characteristics and followed up for 3 years (200 did not reach the end of the follow-up time) from 2016 to 2021. The sample was then dichotomized, on the basis of antipsychotic prescription, to prescribed (CHRAP+, n = 492) or not-prescribed (CHRAP–, n = 225) groups, which were subsequently compared for sociodemographic and clinical characteristics. The risks of conversion to psychosis in CHRAP+ versus CHRAP– groups were tested via survival analysis. Results: Of the 717 CHR individuals, 492 (68.62%) were prescribed antipsychotics; among these antipsychotics, the highest proportion used was for aripiprazole (n = 152), followed by olanzapine (n = 106), amisulpride (n = 76), and risperidone (n = 64). The CHRAP+ group had younger age (t = ...