2019年10月11日(金) 08:40 〜 10:20 第1会場 (メインホール)

Organizer / Chair: Eric YH CHEN (Department of Psychiatry, University of Hong Kong), Co-chair: Ichiro KUSUMI (Department of Psychiatry, Hokkaido University Graduate School of Medicine, Japan), Discussants: ‌Sung-Wan KIM (Department of Psychiatry, Chonnam National University, Korea), Masafumi MIZUNO (Department of Neuropsychiatry, Toho University School of Medicine, Japan)

Psychotic disorders (including schizophrenia and related disorders) involve complex brain dysfunctions affecting up to 3% of the population. They constitute one of the highest disease burdens globally and locally. The conditions inflict devastating consequences for youth and adults at the most productive years in their life. Relapse is a common problem in the treatment of patients with psychotic disorders. While maintenance treatment can help prevent relapse, the long-term use of antipsychotics carries substantial side effects. Empirical data are lacking on the long-term effects of medication discontinuation. The clinical decision to discontinue or continue medication in first-episode psychosis patients who have been free of positive symptoms for a period of time is therefore difficult. The first speaker will present long-term outcome data from a first episode psychosis cohort who were previously randomized into early maintenance treatment or discontinuation in Hong Kong. It was found that patients with early medication discontinuation is associated with poorer clinical outcome after 10 years. The second speaker will investigate an alternative approach to discontinuation, namely dose reduction in remitted psychosis. The speaker will discuss an observational study “Impact of guided antipsychotic dose reduction in patients with psychosis under remitted states: a randomized control trial and prospective follow-up study” which has been launched in Taiwan since 2017. The last speaker will present data from a survey towards clinicians’ views on medication discontinuation in remitted first episode psychosis in Singapore. The data show the ambiguity in clinicians about stopping medication in remitted patients with first episode psychosis due to a lack of clear guidelines, as well as patients’ desire to stop medication.