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Pharmacotherapy of first-episode schizophrenia

Published online by Cambridge University Press:  06 August 2018

Gary Remington
Department of Psychiatry, University of Toronto, Canada
Shitij Kapur
Department of Psychiatry, University of Toronto, Canada
Robert B. Zipursky
Department of Psychiatry, University of Toronto, Canada


Background A growing interest in first-episode schizophrenia reflects the belief that this line of investigation will lead to further developments regarding schizophrenia's aetiology, course and outcome.

Method Evidence from more recent clinical trials involving first-episode schizophrenia is integrated with neuroimaging data, specifically positron emission tomography, to provide direction regarding pharmacotherapy.

Results Individuals with a first episode of schizophrenia appear particularly responsive to pharmacotherapy, as well as quite sensitive to side-effects. At the same time, current clinical and receptor-binding data support the efficacy of low-dose neuroleptic treatment.

Conclusions Early and effective treatment of schizophrenia has been associated with better long-term outcome. Low-dose neuroleptic therapy is an effective treatment strategy and the diminished risk of side-effects with this approach may further enhance compliance and outcome.

Research Article
Copyright © 1998 The Royal College of Psychiatrists 

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