scholarly journals T24. CHANGES IN TELOMERE LENGTH IN YOUNG PEOPLE WITH FIRST EPISODE PSYCHOSIS: A 12-MONTHS FOLLOW-UP STUDY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S240-S240
Author(s):  
Mirian Ayora ◽  
David Fraguas ◽  
Sandra Recio ◽  
Covadonga M Diaz-Caneja ◽  
Maria A Blasco ◽  
...  
Keyword(s):  
Telomere Length ◽  
Young Patients ◽  
Cellular Aging ◽  
First Episode ◽  
Psychotic Episode ◽  
Antipsychotic Treatment ◽  
Published Data ◽  
Healthy Controls ◽  
Significant Difference

Abstract Background Cellular aging is associated with the appearance of several chronic organic diseases, and many neuropsychiatric disorders such as schizophrenia spectrum disorders, which include psychotic disorders. Telomeres are one of the biomarkers of this cellular aging. Researches have shown that shorter telomere length is a biomarker of oxidation and cellular aging. Recent studies have concluded that patients with a first psychotic episode (FEP) have shorter telomere length than healthy controls (HC). However, there is no published data on the change in telomere length in the first years of illness. The purpose of this study is to evaluate the changes in telomere length measured in peripheral blood mononuclear cells (PBMCs) in a sample of patients with early-onset psychosis and healthy subjects. Methods This study included 10 young patients with FEP (50% female, mean age 18.4 years) and 10 young HC (60% female, mean age 16.4 years). PBMCs telomere length was determined using high-throughput quantitative fluorescence in situ hybridization (HT Q-FISH) at baseline and 12-month follow-up. We analysed in our sample of patients if there are significant differences according to the diagnosis and antipsychotic treatment. Results At baseline, we did not find significant differences in telomere length between FEP patients and HC. After one-year follow-up, it was found that telomere length is shorter in patients with FEP than in HC (p=0.007). The diagnostics in the patients’ group were: 60% schizophrenia and 40% other diagnoses (20% psychosis not specified and 20% bipolar disorder). There was no significant difference between changes in telomeres length and diagnosis (p = 0.840). The antipsychotic treatment in the patients’ group after 12 months was: 20% risperidone, 50% aripiprazole, 10% clozapine, 10% paliperidone and 10% quetiapine. We didn′t find a strong association between the shortening of telomeres and the cumulative dose of antipsychotics. Discussion This is one of the first studies where it has been analysed a longitudinal data of telomere length. It is shown that patients with the first episode of psychosis have significantly shorter telomere length than healthy controls. Changes in telomere length during the first years of illness can represent an early marker of accelerated cellular aging. Further studies are needed with a larger sample to know mechanisms responsible for accelerating aging and the role of oxidative stress in the pathogenesis of psychosis.

scholarly journals M192. SENSITIVITY FOR MOTION IS WEAKENED IN FIRST EPISODE PSYCHOSIS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S209-S209
Author(s):  
Francina Badia ◽  
Daniel Linares ◽  
Albert Compte ◽  
Mireia Rosa ◽  
Josep Dalmau ◽  
...  
Keyword(s):  
Motion Perception ◽  
Response To Treatment ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Psychotic Episode ◽  
Antipsychotic Treatment ◽  
Healthy Controls ◽  
Exclusion Criteria ◽  
Motion Sensitivity ◽  
First Psychotic Episode

Abstract Background Perceptual spatial suppression is a phenomenon in which the perceived strength of a stimulus in space is reduced when the stimulus is surrounded by other stimuli. For motion perception, two studies so far have suggested that spatial suppression and sensitivity to motion perception is also reduced in patients with schizophrenia. Studies to date have been conducted in patients with chronic schizophrenia, however, whether these abnormalities are present at the onset of the disorder or whether they emerge during the course of the illness has not been examined, and no study has assessed whether these abnormalities are specific to schizophrenia or whether they are present in other psychotic disorders. Furthermore, if reduced spatial suppression and sensitivity for motion in schizophrenia are related to a glutamatergic hypofunction, as suggested by a recent study (Schallmo et al., 2019), these reductions may be more accentuated in patients who fail to respond to first-line antipsychotic treatment. Methods Sample: 33 patients with a first psychotic episode (16 females, age=16.4±0.6) and 17 healthy controls (9 females, age=17.2±0.61). Exclusion criteria for both groups were: intellectual disability according to DSM-V criteria. For healthy controls, exclusion criteria also included having a first degree relative with a history of psychotic disorder, current or past diagnosis of psychiatrics disorders. Instruments: The perceptual test was performed on a tablet, and consisted of a briefly presented grating (small or large) drifted sideways (the direction was chosen at random with equal probability), in which the participant was instructed to report the perceived direction. Clinical assessment at illness onset and 12 week follow-up: Positive and Negative Symptom Scales (PANSS), Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime version and Structured Clinical Interview for DSM-IV. Non-response to treatment was defined as lack of 50% reduction in PANSS positive or negative scores at 12 weeks, any change in antipsychotics or need for combinations due to lack of clinical response. Psychophysical analysis: Motion sensitivity was estimated independently of lapses of attention, which were assessed by including trials in which the motion stimulus was easily discriminated. Results Patients and healthy controls were homogeneous in age (t=-.720, p=,537) and sex (X2=0.38, p=0.542). In patients, mean treatment response rates was 56.5%. Patients had similar scores of positive and negative symptomatology (positive symptoms= 21±7,13; negative symptoms= 18,4±8,18; general symptoms= 40,7±13,07). At 12 weeks 43,8% had a diagnosis of affective psychosis (bipolar disorder, depressive disorder with psychotic symptoms). Patients with a first psychotic episode, regardless of diagnosis or response to treatment, had less motion sensitivity than healthy controls (f=6.397, p=0.0148). No significant differences were found between groups in surround suppression and no significant correlations were observed between spatial suppression and clinical symptoms. Discussion To our knowledge, this is the first study to find abnormal motion sensitivity in patients with a first episode of psychosis. Our measure of sensitivity, given that it was not contaminated by lapses, indicates that patients had a genuine motion perception deficit rather than an inability to focus on the task. Our results also suggest that motion sensitivity may not be specific to patients with schizophrenia but may also characterize affective psychoses. Larger studies may be needed to clarify whether there is a relationship between motion sensitivity and severity of symptoms and response to treatment.

Sexual Dysfunction in Unmedicated Patients with Schizophrenia and in Healthy Controls

2018 ◽  
Vol 51 (06) ◽  
pp. 251-256 ◽  
Author(s):  
Theresa Dembler-Stamm ◽  
Jana Fiebig ◽  
Andreas Heinz ◽  
Jürgen Gallinat
Keyword(s):  
Sexual Dysfunction ◽  
Gender Effects ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Sexual Activities ◽  
Medication Effects ◽  
Significant Difference ◽  
And Gender

Abstract Introduction Sexual dysfunction figures prominently in patients with schizophrenia; however, medication effects may play a role. The objective of this case control study was to assess differences in the presence of sexual dysfunction in unmedicated patients with schizophrenia versus healthy controls. Methods Sexual dysfunction was assessed using the Derogatis Inventory for Sexual Function self-rating in a cross-sectional design controlling for age and gender effects. A brief sexual anamnesis was applied to describe the psychosocial background of the mostly male sample further. Results Results show a significant difference with patients reporting more problems in most domains and with a significant correlation between severity of psychosis (Positive and Negative Syndrome Scale total scores) and the impairment of orgasm experience. The study revealed reduced sexual activities and less pleasure during sexual activities of patients. Discussion This study implies that schizophrenia has an impact on the presence of sexual dysfunction and that sexual dysfunction is partly independent of antipsychotic treatment. Since the sample consisted mostly of first-episode males, conclusions might only be valid for this subgroup.

scholarly journals Gut microbial biomarkers for the treatment response in first-episode, drug-naïve schizophrenia: a 24-week follow-up study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xiuxia Yuan ◽  
Yunpeng Wang ◽  
Xue Li ◽  
Jiajun Jiang ◽  
Yulin Kang ◽  
...  
Keyword(s):  
Treatment Response ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Follow Up Study ◽  
Α Diversity ◽  
Microbial Biomarkers ◽  
Significant Difference ◽  
Drug Naïve ◽  
Risperidone Treatment

AbstractPreclinical studies have shown that the gut microbiota can play a role in schizophrenia (SCH) pathogenesis via the gut-brain axis. However, its role in the antipsychotic treatment response is unclear. Here, we present a 24-week follow-up study to identify gut microbial biomarkers for SCH diagnosis and treatment response, using a sample of 107 first-episode, drug-naïve SCH patients, and 107 healthy controls (HCs). We collected biological samples at baseline (all participants) and follow-up time points after risperidone treatment (SCH patients). Treatment response was assessed using the Positive and Negative Symptoms Scale total (PANSS-T) score. False discovery rate was used to correct for multiple testing. We found that SCH patients showed lower α-diversity (the Shannon and Simpson’s indices) compared to HCs at baseline (p = 1.21 × 10−9, 1.23 × 10−8, respectively). We also found a significant difference in β-diversity between SCH patients and HCs (p = 0.001). At baseline, using microbes that showed different abundance between patients and controls as predictors, a prediction model can distinguish patients from HCs with an area under the curve (AUC) of 0.867. In SCH patients, after 24 weeks of risperidone treatment, we observed an increase of α-diversity toward the basal level of HCs. At the genus level, we observed decreased abundance of Lachnoclostridium (p = 0.019) and increased abundance Romboutsia (p = 0.067). Moreover, the treatment response in SCH patients was significantly associated with the basal levels of Lachnoclostridium and Romboutsia (p = 0.005 and 0.006, respectively). Our results suggest that SCH patients may present characteristic microbiota, and certain microbiota biomarkers may predict treatment response in this patient population.

Acupuncture in Stroke Rehabilitation

1995 ◽  
Vol 13 (2) ◽  
pp. 81-84 ◽  
Author(s):  
Barbro B Johansson
Keyword(s):  
Postural Control ◽  
Brain Plasticity ◽  
Randomised Trial ◽  
Experimental Studies ◽  
Published Data ◽  
Healthy Controls ◽  
Stroke Patients ◽  
Sensory Stimuli ◽  
Significant Difference

This paper summarises earlier published data on acupuncture and electroacupuncture in stroke patients and discusses possible mechanisms behind the enhanced recovery obtained. Severely hemiparetic patients were entered into a randomised trial within 10 days of their stroke. Acupuncture, including electroacupuncture, was given twice a week for ten weeks to half of the patients, in addition to the daily physiotherapy and occupational therapy given to all. Patients given acupuncture recovered faster and more fully than the control stroke patients, with a significant difference in balance, mobility, activity of daily living and quality of life, an effect that persisted one year after stoke onset. In a follow-up 2 to 3.8 years after the stroke, the postural control of stroke survivors was compared with that of 23, age-matched, healthy subjects. Only half of the control stroke patients could perform the test, and the postural control pattern in those who could take part was significantly different from the healthy controls and acupuncture treated stroke patients, whereas there was no significant difference between acupuncture treated patients and healthy controls. The possible psychological effects of a greater expectation in patients given acupuncture has to be considered. Other studies have shown that special attention given to stroke patients in the early rehabilitation period can accelerate their recovery, but that the difference is usually lost at follow-up. Our results need confirmation, but we have hypothesised that sensory stimulation in the form of acupuncture may release substances that enhance brain plasticity after stroke, an hypothesis than can be tested in experimental studies. Whether or not the effects are specific for acupuncture, or can be obtained also by other kinds of sensory stimuli such as transcutaneous nerve stimulation is currently being investigated.

scholarly journals Assessment of the Telomere Length and Its Effect on the Symptomatology of Parkinson’s Disease

Antioxidants ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 137
Author(s):  
Tina Levstek ◽  
Sara Redenšek ◽  
Maja Trošt ◽  
Vita Dolžan ◽  
Katarina Trebušak Podkrajšek
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Telomere Length ◽  
Repetitive Sequences ◽  
Housekeeping Gene ◽  
Cellular Aging ◽  
Brain Diseases ◽  
Motor Complications ◽  
Telomere Attrition ◽  
Significant Difference

Telomeres, which are repetitive sequences that cap the end of the chromosomes, shorten with each cell division. Besides cellular aging, there are several other factors that influence telomere length (TL), in particular, oxidative stress and inflammation, which play an important role in the pathogenesis of neurodegenerative brain diseases including Parkinson’s disease (PD). So far, the majority of studies have not demonstrated a significant difference in TL between PD patients and healthy individuals. However, studies investigating the effect of TL on the symptomatology and disease progression of PD are scarce, and thus, warranted. We analyzed TL of peripheral blood cells in a sample of 204 PD patients without concomitant autoimmune diseases and analyzed its association with several PD related phenotypes. Monochrome multiplex quantitative PCR (mmqPCR) was used to determine relative TL given as a ratio of the amount of DNA between the telomere and albumin as the housekeeping gene. We found a significant difference in the relative TL between PD patients with and without dementia, where shorter TL presented higher risk for dementia (p = 0.024). However, the correlation was not significant after adjustment for clinical factors (p = 0.509). We found no correlations between TLs and the dose of dopaminergic therapy when the analysis was adjusted for genetic variability in inflammatory or oxidative factors. In addition, TL influenced time to onset of motor complications after levodopa treatment initiation (p = 0.0134), but the association did not remain significant after adjustment for age at inclusion and disease duration (p = 0.0781). Based on the results of our study we conclude that TL contributes to certain PD-related phenotypes, although it may not have a major role in directing the course of the disease. Nevertheless, this expends currently limited knowledge regarding the association of the telomere attrition and the disease severity or motor complications in Parkinson’s disease.

Six-month outcomes of a high intensity exercise programme in young patients with hypertrophic cardiomyopathy: The SAFE-HCM trial

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
J Basu ◽  
S Jayakumar ◽  
C Miles ◽  
G Parry-Williams ◽  
H Maclachlan ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
High Intensity ◽  
Young Patients ◽  
Exercise Adherence ◽  
Exercise Programme ◽  
Exercise Group ◽  
Moderate Intensity ◽  
Psychological Benefits ◽  
Significant Difference

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): Cardiac Risk in the Young Background Moderate intensity exercise training in older patients with hypertrophic cardiomyopathy (HCM) can improve functional capacity, without significant harm. However, younger patients are attracted to high intensity training (HIT) regimes. The SAFE-HCM study demonstrated that an individually tailored, HIT programme in young patients with HCM was feasible, and provided both health and psychological benefits, without an increase in the burden of arrhythmia. Purpose To assess whether observed benefits of a HIT programme in young patients with HCM are sustained at 6 months. Methods Eighty patients with HCM (45.7y+/-8.6) underwent baseline clinical and psychological assessment. Individuals were randomised to a 12-week HIT programme (n = 40) or usual care (n = 40). Baseline evaluation was repeated at 12 weeks (T12). Feasibility, safety, health and psychological benefits were assessed. At 12-weeks individuals were encouraged to continue with the frequency and intensity of physical activity (PA) achieved at the end of the cardiac rehabilitation programme. Participants in the exercise arm were invited to follow-up at 6 months (T6m). Results The majority (83%) of participants completed the 12-week study. At T12 there was no significant difference between groups in the composite arrhythmia safety outcome (p = 0.99). The indices of exercise capacity were significantly improved in the exercise compared to the control group; peak VO2 (+3.7ml/kg/min [CI 1.1,6.3], p = 0.006), VO2/kg at anaerobic threshold (VO2/kgAT) (+2.44ml/kg/min [CI 0.6,4.2], p = 0.009), time to AT (+115s [CI 54.3,175.9], p < 0.001) and exercise time (max ET) (+108s [CI 33.7,182.2], p = 0.005). The exercise group also demonstrated greater reduction in systolic BP (-7.3mmHg [CI -11.7,-2.8], p = 0.002), BMI (-0.8kg/m2 [CI-1.1,-0.4], p < 0.001), anxiety (-2.6 [CI-3.6,-1.6], p= <0.001) and depression (-1.1 [CI -2.0,-0.2], p = 0.015) scores. At T6m patient reported exercise adherence was comparable to baseline PA in 33/34 of the exercise group attending for follow up. Most exercise gains dissipated with the exception of time to AT (p = 0.002), max ET (p = 0.003), VO2/kgAT (p = 0.04) and anxiety score (p < 0.001) (Figure 1). There were no sustained episodes of atrial or ventricular arrhythmias. The incidence of NSVT did not differ between time points (p = 0.09). Conclusion A 12-week HIT programme in young patients with HCM offers considerable gains in fitness and psychological outcomes, with no increase in arrhythmic burden. At T6m exercise levels as well as most physiological adaptations and health benefits returned to baseline, as seen in other studies when formal participation in an exercise programme comes to an end. This highlights the importance of the implementation of strategies to encourage ongoing engagement in PA. Potential solutions include identification of barriers to exercise, as well as adoption of novel tele-rehabilation approaches. Abstract Figure 1 Sustained benefits at T6m

scholarly journals Patterns and predictors of hospitalisation in first-episode psychosis

2001 ◽  
Vol 178 (6) ◽  
pp. 518-523 ◽  
Author(s):  
Attila Sipos ◽  
Glynn Harrison ◽  
David Gunnell ◽  
Shazad Amin ◽  
Swaran P. Singh
Keyword(s):  
Negative Symptoms ◽  
First Episode Psychosis ◽  
Psychiatric Services ◽  
First Episode ◽  
Psychotic Episode ◽  
Duration Of Untreated Illness ◽  
Specialist Services ◽  
Increased Risk ◽  
Episode Psychosis

BackgroundLittle is known about predictors of hospitalisation in patients with first-episode psychosis.AimsTo identify the pattern and predictors of hospitalisation of patients with a first psychotic episode making their first contact with specialist services.MethodThree-year follow-up of a cohort of 166 patients with a first episode of psychosis making contact with psychiatric services in Nottingham between June 1992 and May 1994.ResultsEighty-eight (53.0%) patients were admitted within 1 week of presentation; 32 (19.3%) were never admitted during the 3 years of follow-up. Manic symptoms at presentation were associated with an increased risk of rapid admission and an increased overall risk of admission; negative symptoms and a longer duration of untreated illness had an increased risk of late admission.ConclusionsCommunity-oriented psychiatric services might only delay, rather than prevent, admission of patients with predominantly negative symptoms and a longer duration of untreated illness. First-episode studies based upon first admissions are likely to be subject to selection biases, which may limit their representativeness.

scholarly journals The Role of Butyric Acid in Treatment Response in Drug-Naïve First Episode Schizophrenia

2021 ◽  
Vol 12 ◽  
Author(s):  
Xue Li ◽  
Xiaoduo Fan ◽  
Xiuxia Yuan ◽  
Lijuan Pang ◽  
Shaohua Hu ◽  
...  
Keyword(s):  
Treatment Response ◽  
Butyric Acid ◽  
Serum Levels ◽  
First Episode ◽  
Healthy Controls ◽  
Significant Difference ◽  
Drug Naïve ◽  
First Episode Schizophrenia ◽  
Risperidone Treatment

Background: Butyric acid, a major short-chain fatty acid (SCFA), has an important role in the microbiota–gut–brain axis and brain function. This study investigated the role of butyric acid in treatment response in drug-naïve first episode schizophrenia.Methods: The study recruited 56 Chinese Han schizophrenia inpatients with normal body weight and 35 healthy controls. Serum levels of butyric acid were measured using Gas Chromatography-Mass Spectrometer (GC-MS) analysis at baseline (for all participants) and 24 weeks after risperidone treatment (for patients). Clinical symptoms were measured using the Positive and Negative Syndrome Scale (PANSS) for patients at both time points.Results: At baseline, there was no significant difference in serum levels of butyric acid between patients and healthy controls (p = 0.206). However, there was a significant increase in serum levels of butyric acid in schizophrenia patients after 24-week risperidone treatment (p = 0.030). The PANSS total and subscale scores were decreased significantly after 24-week risperidone treatment (p's < 0.001). There were positive associations between baseline serum levels of butyric acid and the reduction ratio of the PANSS total and subscale scores after controlling for age, sex, education, and duration of illness (p's < 0.05). Further, there was a positive association between the increase in serum levels of butyric acid and the reduction of the PANSS positive symptoms subscale scores (r = 0.38, p = 0.019) after controlling for potential confounding factors.Conclusions: Increased serum levels of butyric acid might be associated with a favorable treatment response in drug-naïve, first episode schizophrenia. The clinical implications of our findings were discussed.

scholarly journals INTEGRATION OF COMPLEMENTARY BIOMARKERS IN PATIENTS WITH FIRST EPISODE PSYCHOSIS: RESEARCH PROTOCOL OF A PROSPECTIVE FOLLOW UP STUDY

2019 ◽  
Author(s):  
Petra ◽  
Martina Rojnic Kuzman ◽  
Porin Makaric ◽  
Dina Bosnjak Kuharic ◽  
Ivana Kekin ◽  
...  
Keyword(s):  
Genome Wide Association Study ◽  
Single Photon ◽  
Single Gene ◽  
Photon Emission ◽  
Blood Perfusion ◽  
First Episode ◽  
Emission Computed Tomography ◽  
Healthy Controls ◽  
Post Mortem

In this project, we recruited a sample of 150 patients with first episode of psychosis with schizophrenia features (FEP) and 100 healthy controls. We assessed the differences between these two groups, as well as the changes between the acute phase of illness and subsequent remission among patients over 18-month longitudinal follow-up. The assessments were divided into four work packages (WP): WP1- psychopathological status, neurocognitive functioning and emotional recognition; WP2- stress response measured by saliva cortisol during a stress paradigm; cerebral blood perfusion in the resting state (with single photon emission computed tomography (SPECT) and during activation paradigm (with Transcranial Ultrasonography Doppler (TCD); WP3-post mortem analysis in histologically prepared human cortical tissue of post mortem samples of subjects with schizophrenia in the region that synaptic alteration was suggested by WP1 and WP2; WP4- pharmacogenetic analysis (single gene polymorphisms and genome wide association study (GWAS). We expect that the analysis of these data will identify a set of markers that differentiate healthy controls from patients with FEP, and serve as an additional diagnostic tool in the first episode of psychosis, and prediction tool which can be then used to help tailoring individualized treatment options. In this paper, we describe the project protocol including aims and methods and provide a brief description of planned post mortem studies and pharmacogenetic analysis.

scholarly journals Antipsychotic Treatment Effectiveness in First Episode of Psychosis: PAFIP 3-Year Follow-Up Randomized Clinical Trials Comparing Haloperidol, Olanzapine, Risperidone, Aripiprazole, Quetiapine, and Ziprasidone

2020 ◽  
Vol 23 (4) ◽  
pp. 217-229 ◽  
Author(s):  
Marcos Gómez-Revuelta ◽  
José María Pelayo-Terán ◽  
María Juncal-Ruiz ◽  
Javier Vázquez-Bourgon ◽  
Paula Suárez-Pinilla ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Dropout Rate ◽  
Treatment Discontinuation ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Open Label ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Treatment Groups

Abstract Background Different effectiveness profiles among antipsychotics may be a key point to optimize treatment in patients suffering a first episode of psychosis to impact on long-term outcome. The aim of this study is to compare the clinical effectiveness of olanzapine, risperidone, haloperidol, aripiprazole, ziprasidone, and quetiapine in the treatment of first episode of psychosis at 3-year follow-up. Method From February 2001 to January 2011, 2 phases of a prospective, randomized, open-label study were undertaken. A total of 376 first-episode drug-naïve patients were randomly assigned to olanzapine (n = 55), risperidone (n = 63), haloperidol (n = 56), aripiprazole (n = 78), ziprasidone (n = 62), or quetiapine (n = 62) and followed up for 3 years. The primary effectiveness measure was all cause of treatment discontinuation. In addition, an analysis based on intention-to-treat principle was conducted in the analysis for clinical efficacy. Results The overall dropout rate at 3 years reached 20.75%. Treatment discontinuation rates were significantly different among treatment groups (olanzapine = 69.09, risperidone = 71.43, aripiprazole = 73.08%, ziprasidone = 79.03%, haloperidol = 89.28%, and quetiapine = 95.53%) (χ2 = 79.86; P = .000). Statistically significant differences in terms of lack of efficacy, adherence, and tolerability were observed among treatment groups along the 3-year follow-up, determining significant differences in time to all-cause discontinuation (log-rank = 92.240; P = .000). Significant differences between treatments were found in the categories of sleepiness/sedation, increased sleep duration, akinesia, weight gain, ejaculatory dysfunction, extrapyramidal-symptoms, and amenorrhea. Conclusions Olanzapine, risperidone, and aripiprazole presented advantages for the first-line treatment of first episode of psychosis in terms of effectiveness. Identifying different discontinuation patterns may contribute to optimize treatment selection after first episode of psychosis. ClinicalTrials.gov Identifier: NCT02526030 https://clinicaltrials.gov/show/NCT02526030

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