Abstract：
The issue of antipsychotic (dis)continuation has been a long-standing clinical dilemma. While the routine usage of antipsychotic is associated with side effects and stigma, short-term evidence suggest that the risk of relapse is heightened following antipsychotics withdrawal. Clinical guidelines therefore propose a one to two years duration of maintenance treatment upon remission in first episode psychosis (FEP), but guidance beyond which remains unclear. Only two controlled studies have addressed the long-term consequences of antipsychotic discontinuation. While Wunderink et al. concluded that dose reduction is associated with a higher rate of recovery, Hui et al. found discontinuation to be associated with better clinical outcomes. Data from Hui et al.\'s study further suggests that treatment should be maintained for at least the first three years upon remission in FEP in order reduce the risk of relapse, as well as subsequent poor long-term outcome. It is noted that the two studies not only differ in outcome measures, but also in their strategies of \"antipsychotic discontinuation\". Considering that discontinuation is a more compelling option to most patients, it may therefore be more clinically relevant. More long-term follow-up discontinuation studies are needed to provide further evidence in the development of treatment guidelines for FEP.
摘要：
抗精神病药（disis）的延续问题一直是一个长期存在的临床难题。虽然抗精神病药的常规使用与副作用和污名有关，短期证据表明,抗精神病药物停药后复发风险增加.因此，临床指南建议在首发精神病（FEP）缓解后维持治疗一到两年，但除此之外的指导仍不清楚。只有两项对照研究解决了抗精神病药物停药的长期后果。而Wunderink等人。得出结论，剂量减少与较高的恢复率有关，Hui等人。发现停药与更好的临床结局相关。数据来自Hui等人。这项研究进一步表明，治疗应在FEP缓解后至少维持前三年，以降低复发风险，以及随后糟糕的长期结果。值得注意的是，这两项研究不仅在结果衡量标准上有所不同，而且在他们的“抗精神病药物停药”策略中。考虑到停药对大多数患者来说是更有吸引力的选择，因此，它可能更具临床相关性。需要更多的长期随访停药研究，为FEP治疗指南的制定提供进一步的证据。
