Psychiatric hospitalization following antipsychotic medication cessation in first episode psychosis.

Background: There are questions about the risk-benefit balance of longer-term antipsychotic medication treatment following first episode psychosis, especially in relation to relapse because of dopamine supersensitivity following treatment cessation. Aim: The purpose of this study was to determine whether hospitalization rates in first episode psychosis patients are associated with length of initial oral antipsychotic medication exposure. Methods: We examined psychiatric hospitalization rates in patients experiencing first episode of psychosis from the total population of Sweden between 1 January 2007-31 December 2016 (n=7043). We categorised patients by the length of first antipsychotic treatment (<6 months, 6 months to <1 year, 1 year to <2 years, 2 years to <5 years and > 5 years). Results: Compared to those treated for <6 months, individuals receiving oral antipsychotic medications for > 5 years had less than half the cumulative incidence of hospitalization at all times between 1-4 years after treatment cessation. Conclusion: We found no evidence that hospitalization rates increased with increasing baseline antipsychotic exposure.