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Antipsychotic Treatment in People at Clinical High Risk for Psychosis: A Narrative Review of Suggestions for Clinical Practice.
Di Lisi, Alessandro; Pupo, Simona; Menchetti, Marco; Pelizza, Lorenzo.
Afiliación
  • Di Lisi A; From the Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum Università di Bologna, Bologna.
  • Pupo S; Pain Therapy Service, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
  • Menchetti M; From the Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum Università di Bologna, Bologna.
  • Pelizza L; From the Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum Università di Bologna, Bologna.
J Clin Psychopharmacol ; 44(5): 502-508, 2024.
Article en En | MEDLINE | ID: mdl-39250139
ABSTRACT

PURPOSE:

The "early intervention" paradigm in psychiatry holds significant promise for preventing psychosis. Recent evidence showed that individuals at clinical high risk for psychosis (CHR-P) with antipsychotic (AP) prescription at baseline have higher psychosis transition rates compared with those without AP, although the underlying cause remains unclear. In this article, we reviewed international guidelines on early intervention in CHR-P people, paying specific attention to clinical recommendations on AP treatment. Then, we comment on these suggestions in the light of recent empirical evidence examining AP prescription in CHR-P populations within "real-world" clinical settings.

METHODS:

This search was conducted on PubMed/MEDLINE, PsycINFO, EMBASE, and Google, looking for both "Guidelines AND CHR-P OR UHR OR Early Psychosis."

RESULTS:

International guidelines generally recommend not using AP as first-line treatment, but only when psychosocial interventions have failed. CHR-P people with AP drug showed high prevalence rates and had more severe clinical picture at entry. Is this a "warning signal" for potentially higher psychosis transition risk? Is it a direct AP iatrogenic effect? Is it possible to detect specific CHR-P subgroup that may benefit from AP? These are the questions that this article seeks to explore.

CONCLUSIONS:

The current framework for identifying CHR-P subjects has defined psychometric criteria mainly based on positive symptoms. In our opinion, this is reductive, especially for evaluating therapeutic outcomes and prognosis. A more comprehensive assessment considering quality of life, psychiatric comorbidity, persistent negative symptoms, subjective experience of CHR-P psychopathology, and social/personal recovery is thus needed.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos Psicóticos / Antipsicóticos Límite: Humans Idioma: En Revista: J Clin Psychopharmacol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trastornos Psicóticos / Antipsicóticos Límite: Humans Idioma: En Revista: J Clin Psychopharmacol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos