La médication

Observance au traitement

Approximately 80% of patients with the first-episode schizophrenia reach symptomatic remission after antipsychotic therapy. However, within two years most of them relapse, mainly due to low levels of insight into the illness and nonadherence to their oral medication. 

Prikryl, R., Prikrylova Kucerova, H., Vrzalova, M., & Ceskova, E. (2012). Role of long-acting injectable second-generation antipsychotics in the treatment of first-episode schizophrenia: a clinical perspective. Schizophr Res Treatment, 2012, 764769. doi:10.1155/2012/764769
Antipsychotic medication is often effective in the treatment of psychotic symptoms in schizophrenia spectrum disorders, but it has questionable effects on negative symptoms and limited effect on cognitive function. Antipsychotics often reduce the risk of relapse after remission of psychotic symptoms – at least in the short term. This is the rationale for recommending maintenance treatment with antipsychotic medication in national and international guidelines for the treatment of schizophrenia. However, current guidelines do not provide recommendations as to which patients might be able to discontinue their antipsychotic medication without relapsing. More knowledge is needed to give specific and tailored recommendations to the individual about treatment with antipsychotic medication.
Studies of first-episode psychosis have shown that some 50 to 60% of the patients were in remission regarding psychotic symptoms at 10-year follow-up and approximately half of the patients had discontinued antipsychotic medication. The studies showed that a substantial group of patients with firstepisode psychosis in the long term can manage without antipsychotic medication. (p2)

Sturup, A. E., Jensen, H. D., Dolmer, S., Birk, M., Albert, N., Nielsen, M., . . . Nordentoft, M. (2017). TAILOR - tapered discontinuation versus maintenance therapy of antipsychotic medication in patients with newly diagnosed schizophrenia or persistent delusional disorder in remission of psychotic symptoms: study protocol for a randomized clinical trial. Trials, 18(1), 445.

Liens vers ces références: 
Morgan C, Lappin J, Heslin M, Donoghue K, Lomas B, Reininghaus U, et al. Reappraising the long-term course and outcome of psychotic disorders: the AESOP-10 study. Psychol Med. 2014;44:2713–26.
Gotfredsen D, Wils RS, Hjorthøj C, Austin SF, Albert N, Secher RG, et al. Stability and development of psychotic symptoms and the use of antipsychotic medication—long-term follow-up. Psychol Med. 2017;47(12): 2118–29.