Gomez-Revuelta, MarcosPelayo-Teran, Jose MariaJuncal-Ruiz, MariaVazquez-Bourgon, JavierSuarez-Pinilla, PaulaRomero-Jimenez, RodrigoSetien-Suero, EstherAyesa-Arriola, RosaCrespo-Facorro, Benedicto2023-02-082023-02-082020-01-22Gómez-Revuelta M, Pelayo-Terán JM, Juncal-Ruiz M, Vázquez-Bourgon J, Suárez-Pinilla P, Romero-Jiménez R, et al. Antipsychotic Treatment Effectiveness in First Episode of Psychosis: PAFIP 3-Year Follow-Up Randomized Clinical Trials Comparing Haloperidol, Olanzapine, Risperidone, Aripiprazole, Quetiapine, and Ziprasidone. Int J Neuropsychopharmacol. 2020 Apr 23;23(4):217-229.http://hdl.handle.net/10668/14998Different 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. 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. 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. 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.enAttribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/antipsychoticsfirst-episode-psychosisschizophreniaAdolescentAdultAntipsychotic AgentsAripiprazoleFemaleFollow-Up StudiesHaloperidolHumansMaleOlanzapineOutcome Assessment, Health CarePiperazinesPsychotic DisordersQuetiapine FumarateRisperidoneSchizophreniaThiazolesYoung Adultresearch article31974576open accessTerapéuticaOlanzapinaTrastornos psicóticosEfectividadPreparaciones farmacéuticasAumento de pesoAntipsicóticosAmenorreaPacientes10.1093/ijnp/pyaa0041469-5111PMC7177160https://academic.oup.com/ijnp/article-pdf/23/4/217/33115717/pyaa004.pdfhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177160/pdf