Rational pharmacotherapy in early psychosis

Abstract

Background: An increased focus in research specific to first-episode schizophrenia has provided a rapidly growing body of evidence that can be directly translated to clinical practice. Aims: To provide clinical recommendations specific to effective pharmacotherapy of first-episode schizophrenia. Method: Evidence from clinical trials focused on the first-episode population is combined with data from other areas of investigation. Results: In first-episode psychosis, when to initiate treatment is not always clear, being intimately linked to challenges regarding early detection and diagnosis. There may be differences in antipsychotic dosing, patterns of response and sensitivity to side-effects. Adherence appears to be even more problematic at this stage. Conclusions: Clinicians currently treating early psychosis have considerably more information to guide their decision-making. However, the speed at which the field is growing is a reminder to treat this knowledge as a work in progress.