Pharmacological Management of First-Episode Schizophrenia and Related Nonaffective Psychoses
- 1 January 2003
- journal article
- review article
- Published by Springer Science and Business Media LLC in Drugs
- Vol. 63 (21), 2265-2283
- https://doi.org/10.2165/00003495-200363210-00001
Abstract
Schizophrenia is a severe mental illness characterised by abnormalities of thought and perception that affects 1–2% of the population. Patients who experience a first episode of schizophrenia should be treated early and optimally with antipsychotic agents to lessen the morbidity of the initial episode and possibly improve the course of the illness. Positive psychotic symptoms remit in the majority of patients who are treated with adequate trials of antipsychotic medications, but most relapse within 1 year. Non-adherence is strongly related to the likelihood of recurrence of symptoms. Innovative programmes that integrate early intervention, psychosocial treatments and atypical antipsychotic pharmacotherapy show promise in improving outcomes. The available research supports the use of antipsychotic medications early in the first-episode of schizophrenia and for at least 1 year after remission of positive symptoms. Antidepressants, benzodiazepines and mood stabilisers have roles in the acute and maintenance phases of treatment for some patients. Atypical antipsychotics represent a great advance in the treatment of first-episode schizophrenia with strong evidence for greater tolerability with equal or better therapeutic efficacy. Future research will further define their roles in treatment and hopefully identify targets for prevention of first-episode schizophrenia.Keywords
This publication has 112 references indexed in Scilit:
- Atypical and Conventional Antipsychotic Drugs in Treatment-Naive First-Episode Schizophrenia: A 52-Week Randomized Trial of Clozapine Vs ChlorpromazineNeuropsychopharmacology, 2003
- Risperidone, 2 mg/day vs. 4 mg/day, in First-Episode, Acutely Psychotic PatientsThe Journal of Clinical Psychiatry, 2002
- PrefaceCurrent Opinion in Psychiatry, 2002
- OlanzapineDrugs, 2001
- Delayed Detection of Psychosis: Causes, Consequences, and Effect on Public HealthAmerican Journal of Psychiatry, 2000
- Changes in Use of Valproate and Other Mood Stabilizers for Patients With Schizophrenia From 1994 to 1998Psychiatric Services, 2000
- Diagnostic stability of first-episode psychosisThe British Journal of Psychiatry, 1999
- The Scottish first episode schizophrenia studyActa Psychiatrica Scandinavica, 1989
- Sodium Valproate and Tardive DyskinesiaThe British Journal of Psychiatry, 1979
- Factorial invariance across gender for the primary symptom dimensions of the SCL‐90British Journal of Social and Clinical Psychology, 1977