Antipsychotic medication is effective for symptomatic treatment in schizophrenia-spectrum disorders. Patients who have remitted from their psychotic symptoms and continue to use medication have a lower risk of relapse than individuals who reduce dosage or discontinue at an early stage. Most international guidelines recommend continuation with antipsychotic medication for at least one year. However, in clinical practice, we see that patients often have a strong wish to stop earlier due to side-effects that affect their everyday social functioning. Randomized intervention studies comparing the long-term effects of maintenance treatment versus early discontinuation are scarce and inconclusive. Psychiatrists, patients and family are therefore unsure which regime to follow: to continue or not to continue? That is the question.
The pressure to find answers has been felt worldwide and four independent currently address the topic of antipsychotic (dis)continuation: HAMLETT (www.hamlett.nl) covering the Netherlands, TAILOR in Copenhagen (Denmark), REDUCE in Melbourne (Australia) and RADAR throughout the United Kingdom. This international workshop brings together junior and senior researchers from different disciplines to better streamline our joint efforts on this important research topic and shape collaboration. Especially given the longitudinal nature of these studies, it is important to build a strong network together to facilitate international and interdisciplinary collaboration. Moreover, as these international results can actually impact patient care across the world, joint discussions on the interpretation of our future results is needed to translate these into health care guidelines. The organizing committee is determined to make this workshop an impactful and memorable event in September 2020.
Due to the COVID-19 circumstances part of the workshop will be online.
MONDAY (Dutch participants)
11.30 Welcome Staff Lorentz Center
11.45 Overview and what will everyone give & take Prof. Dr. Iris Sommer and Dr. Marieke Begemann
12.15 Opening lecture Moderator: Prof. Dr. Iris Sommer
HAMLETT OPHELIA Dr. Marieke Begemann Dr. Sanne Schuite-Koops
14:00 Lecture round Moderator: Prof. Dr. Lieuwe de Haan
WP1: Symptoms & relapse WP1: Cognition (BACS, PRAAT) WP1: Neuroimaging WP3: Prognostic modelling Discussion Prof. Dr. Lieuwe de Haan – psychiatrist and expert in early psychosis and schizophrenia Alban Voppel - PhD student investigating speech and cognition in psychosis Priscilla Oomen – PhD student specializing in MRI Dr. Joran Lokkerbol, Trimbos expert
15.00 Plenary discussion
15.15 Open space session Dr. Marieke Begemann
Today’s session will be about the presented outcome measures. Participants are encouraged to discuss the possibilities of streamlining data processing and combining outcome measures in analyses. 1. Symptom and relapse measurements 2. Cognition 3. Neuroimaging 4. Prognostic modelling 5. [To leave room for input for participants, this theme will be decided during the meeting]
17.00 Plenary discussion: Recap day 1 Each session host present a summary of key points resulting from their group session.
End product: Syntaxes will be written based on preliminary data in preparation of final data analyses.
17.30 Drinks and networking Poster presentations by junior researchers, presenting their PhD project
19:30 End of day 1
TUESDAY (Dutch participants)
9.30 Review day one, overview day two Moderator: Prof. Dr. Nico van Beveren
9.45 Lecture round Moderator: Dr. Nico van Beveren
10.30 WP2: EMA WP2: BeHapp WP4: Blood-omics WP6: Gene-environment Discussion Chris Geraets – expert in EMA measurements Prof. Dr. Martien Kas –behavioral neuroscience Karin Huizer, MD - finishing PhD Neuropathology Dr. Sinan Gülöksüz – genetic data analyst
10.45 Coffee/tea break
12.00 Lecture round Moderator: Dr. Nynke Boonstra
WP5: Personal Recovery WP7: Implementation Patients & family members Dr. Nynke Boonstra & Bram-Sieben Rosema Dr. Martijn Kikkert Karin Groen - family organization Ypsilon Martijn vd Brink - peer support worker
14.30 Open space session Moderator: Dr. Martijn Kikkert
Today’s session will be about the presented outcome measures. Participants are encouraged to discuss the possibilities of streamlining data processing and combining outcome measures in analyses. 6. EMA 7. BeHapp 8. Bloodomics 9. Gene-environment 10. Personal Recovery 11. Implementation [To leave room for input for participants, this theme will be decided during the meeting]
16.30 Plenary discussion Each session host present a summary of key points resulting from their group session.
End product: Syntaxes will be written based on preliminary data in preparation of final data analyses. A future plan will be made about how to sustain participation in this long-term HAMLETT/OPHELIA cohort.
17.00 Evening program and dinner
WEDNESDAY (Dutch participants)
9.30 Optional: Time to meet with working groups
12.00 Review day two, overview today Prof. Dr. Filip Smit
12.15 Plenary lecture Moderator: Prof. Dr. Filip Smit
Instrumental Variables approach Dr. Joran Lokkerbol
14.00 Lectures round 1: Personalized medicine Moderator: Prof. Dr. Filip Smit
Gender Issues Childhood trauma Noorse data Prof. Dr. Iris Sommer (UMC Groningen) Dr. Marieke Begemann (UMC Groningen) Sanne Hoekstra
15.00 Open space session Moderator: Dr. Joran Lokkerbol
Today’s session will be about the current trials. Participants are encouraged to discuss common pitfalls and think about a general approach to handling them. 1. Cost effectiveness: what do we measure? 2. Safety analyses: how may outcomes jeopardize your trial? 3. What gender issues can we expect and how do we handle this in our analyses? 4. How to handle dropouts? 5. Promoting an individually adapted participation vs research protocol: tips and tricks 6. How can inclusion rate be increased? 7. [Decided during meeting to leave room for input]
17.00 Plenary discussion Each session host present a summary of key points resulting from their group session.
End product: A summary describing the most important hurdles and difficulties encountered in HAMLETT/OPHELIA, together with the (joint) decisions that were made to overcome these issues, and identify common limitations of these kind of studies.
17.30 Evening program including dinner Dutch participants
THURSDAY – all participants
8.00 Introduction participants Prof. Dr. Jim van Os
8.45 Lectures round 1: Current trials Moderator: Prof. Dr. Jim van Os
RADAR REDUCE TAILOR HAMLETT Dr Ruth Cooper - RADAR senior researcher Amber Weller – REDUCE coordinator Dr. Nikolai Albert – TAILOR coordinator Dr. Marieke Begemann – HAMLETT coordinator
10.00 Coffee Break PhD pitches: PhD students of the different trials will prepare a (digital) poster and short pitch. These (digital) presentations will take place in different rooms.
10.45 Lecture round 2” Previous trials Moderator: Dr. Roberto Bakker
The MESIFOS STUDY Prof. Dr. Lex Wunderink – PI of the first large-scale discontinuation RCT,performed in NL The Hui study Prof. Dr. Eric Chen – performed a large-scale longitudinal trial in Hong Kong 2018.
11.30 Open space session Moderator: Prof. Dr. Wim Veling
Today’s session will be about the current trials. Participants are encouraged to discuss common pitfalls and think about a general approach to handling them. 1. What common pitfalls are shared between these international studies? 2. What common definitions can we use in the different trials? 3. What interim analyses are planned across trials, and how can we combine data? 4. Promoting individually adapted participation vs research protocol: tips and tricks 5. [To leave room for input for participants, this theme will be decided during the meeting]
12.30 Plenary discussion Each session host present a summary of key points resulting from their group session.
13.00 Commitment session Moderator: Prof. Dr. Iris Sommer 1. Discuss list of action and distribution of tasks across participants. 2. Which variables can be combined for a joint article? 3. Forming an author group that will be registered on Pubmed for joint publications 4. Which opportunities are there to organize joint symposia/meetings?
14.00 Plenary discussion Prof. Dr. Iris Sommer
14.30 Closing remarks Prof. Dr. Iris Sommer
End product day 4: A summary describing common limitations of these kind of studies. These can be incorporated in the discussion section, when researchers will be writing up the results in the final research articles. Joint research article(s) will set up, authors group is registered on PubMed. Working groups for future collaborative topics, to streamline data analyses between the international studies as much as possible. Plan next meeting.
15.00 End of day 4.