Insomnia as a predictor for symptom worsening following antipsychotic withdrawal in schizophrenia

Eran Chemerinski; Beng-Choon Ho; Michael Flaum; Stephan Arndt; Frank Fleming; Nancy C Andreasen

doi:10.1053/comp.2002.34627

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Insomnia as a predictor for symptom worsening following antipsychotic withdrawal in schizophrenia

Journal article

Peer reviewed

Insomnia as a predictor for symptom worsening following antipsychotic withdrawal in schizophrenia

Eran Chemerinski, Beng-Choon Ho, Michael Flaum, Stephan Arndt, Frank Fleming and Nancy C Andreasen

Comprehensive psychiatry, Vol.43(5), pp.393-396

09/2002

DOI: 10.1053/comp.2002.34627

PMID: 12216015

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Abstract

Sleep disturbances have been associated with schizophrenia, and are an especially prominent feature during the prodrome preceding psychotic relapse. In this study, we examined the changes in sleep quality following withdrawal of antipsychotic treatment, as well as the predictive value of sleep disturbances on symptom exacerbation. One hundred twenty-two patients with schizophrenia, schizophreniform disorder, or schizoaffective disorder underwent a 3-week medication wash-out prior to neuroimaging studies. Sleep quality was rated using items on the Hamilton Rating Scale for Depression (HAM-D), while symptom severity was measured using the Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS). Sleep quality deteriorated progressively following antipsychotic discontinuation. Total insomnia score prior to antipsychotic withdrawal had a significant effect on the severity of psychotic symptoms at the last weekly assessment, while baseline terminal insomnia had a significant effect on disorganized symptoms at the end of the medication-free period. These findings were independent of baseline symptom severity. Our findings suggest that schizophrenia patients with sleep disturbances are at a greater risk for worsening of positive symptoms after antipsychotic discontinuation. The implications of these findings in research and clinical settings are discussed.

Severity of Illness Index

Sleep Initiation and Maintenance Disorders - etiology

Antipsychotic Agents - adverse effects

Humans

Male

Schizophrenia - complications

Sleep - drug effects

Antipsychotic Agents - administration & dosage

Psychiatric Status Rating Scales

Adult

Female

Schizophrenia - drug therapy

Substance Withdrawal Syndrome - physiopathology

Substance Withdrawal Syndrome - psychology

Details

Title: Subtitle: Insomnia as a predictor for symptom worsening following antipsychotic withdrawal in schizophrenia
Creators: Eran Chemerinski - Mental Health Clinical Research Center, Department of Psychiatry, The University of Iowa College of Medicine, Iowa City, IA 52242, USA
Beng-Choon Ho
Michael Flaum
Stephan Arndt
Frank Fleming
Nancy C Andreasen
Resource Type: Journal article
Publication Details: Comprehensive psychiatry, Vol.43(5), pp.393-396
DOI: 10.1053/comp.2002.34627
PMID: 12216015
NLM abbreviation: Compr Psychiatry
ISSN: 0010-440X
eISSN: 1532-8384
Publisher: United States
Grant note: MH40856 / NIMH NIH HHS MH43271 / NIMH NIH HHS MH19113 / NIMH NIH HHS
Language: English
Date published: 09/2002
Academic Unit: Psychiatry; Iowa Neuroscience Institute; Biostatistics; Nursing; Injury Prevention Research Center
Record Identifier: 9984003913902771

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