Predictors of medication discontinuation by patients with first-episode schizophrenia and schizoaffective disorder

Delbert G. Robinson, Margaret G. Woerner, Jose Ma J. Alvir, Robert M. Bilder, Gregory A. Hinrichsen, Jeffrey A. Lieberman

Research output: Contribution to journalArticlepeer-review

237 Scopus citations

Abstract

Background: Enhancing medication adherence early in the course of schizophrenia and schizoaffective disorder may substantially improve long-term course. Although extensively studied in multi-episode patients, little data exist on medication adherence by first-episode patients. Method: Medication adherence was assessed during the first year of treatment and following recovery from the first relapse in patients treated by a standardized medication algorithm. Results: During the first year of treatment, patients with poorer premorbid cognitive functioning were more likely to stop antipsychotics (t=-2.54, df=75, p=0.01). Parkinsonian side effects increased the likelihood (hazard ratio=41.22; 95% CI=2.30, 737.89; p=0.01), and better executive function decreased the likelihood (hazard ratio=0.40; 95% CI=0.18, 0.88; p=0.02) that patients discontinued maintenance medication after a first relapse. Conclusion: Interventions to ameliorate cognitive deficits and Parkinsonian side effects may enhance treatment adherence.

Original languageEnglish
Pages (from-to)209-219
Number of pages11
JournalSchizophrenia Research
Volume57
Issue number2-3
DOIs
StatePublished - 1 Oct 2002
Externally publishedYes

Keywords

  • Antipsychotic agents
  • Cognition
  • Neuropsychological tests
  • Patient compliance
  • Schizophrenia

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