New Advances in Pharmacotherapy for Early Psychosis

Aim: This review examines the use of antipsychotic medication during the early years of psychosis.

Methods: A selective literature review was conducted.

Results: The early years of schizophrenia represent a critical period for intervention. Importantly, first-episode patients differ from those with chronic schizophrenia in several important respects. While treatment response to antipsychotic medication is better, the risk of relapse is also higher. While both first- and second-generation antipsychotics are very effective in reducing symptoms, there are tolerability and some efficacy advantages for the second-generation antipsychotics in first-episode psychosis. Poor medication adherence is a significant problem in early psychosis that is linked to relapse and poses a major barrier to optimizing outcomes. Treatment strategies should focus on, among other things, improving antipsychotic medication adherence.

Conclusions: The early years of psychosis offer the best opportunity for achieving optimal outcomes. Maintaining symptomatic remission is central to achieving functional recovery.