Medications for first-episode psychosis patients may be unsuitable

Many patients with first-episode psychosis may receive medications that do not meet guidelines recommended for the treatment of an initial episode, according to the NIH.

In a press release, the NIH cites research suggesting that almost 40% of people presenting with first-episode psychosis in community mental health centers may benefit from changes in treatment options. The Recovery After an Initial Schizophrenia Episode (RAISE) Early Treatment Program study followed 404 individuals aged 15 to 40 years who presented for treatment at 34 community-based clinics in 21 states. Each participant had been treated with antipsychotic medications for 6 months or less.

Among enrollees, 39.4% were identified as patients who might benefit from a different therapy. Of those, 23.3% were prescribed multiple antipsychotics, and 8.8% were prescribed doses of antipsychotics that were higher than typical. Concomitant antidepressants were prescribed to 36.5% of patients without a clear indication; 1.2% were prescribed stimulants.

Olanzapine, which is not recommended for first-episode psychotic events, was prescribed to 32.1% of the patients.

“Our data were for prescriptions individuals received before they started the RAISE Early Treatment Program study. Community mental health clinicians usually have extensive experience treating individuals with multi-episode psychosis,” Delbert Robinson, MD, of the Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, said in a press release. “The challenge for the field is to develop ways to transmit the specialized knowledge about first-episode treatment to busy community clinicians.”