International clinical practice guidelines recommend several practical steps in the monitoring of patients in a prepsychotic
state (Table 3),23 but caution against the use of antipsychotic agents unless the patient meets diagnostic criteria for a psychotic disorder.
Cornblatt and her associates prescribed either antidepressants or second-generation antipsychotics to 48 adolescents who met criteria for prepsychotic schizophrenia (J.
The use of antipsychotics to treat prepsychotic adolescents is on the rise despite a lack of data, and more research is needed before such treatment becomes a standard practice, the researchers said.
Recent studies have shown independent therapeutic effects of antipsychotic medication and cognitive-behavioral therapy during the interval between the first noticeable prepsychotic
changes and the onset of positive psychotic symptoms--findings that should compel investigators to ramp up research efforts to identify optimal prodromal management strategies, he said.
Schizophrenia prodrome is an early or prepsychotic
state that is a deviation from an individual's usual behavior and experience.
RELATED ARTICLE: PIER Looks for Prepsychotic
Cornblatt based her remarks on initial results from a 3-year study of 82 patients enrolled in a treatment and research program for adolescents who are considered to be in the prodromal, or prepsychotic
, stage of schizophrenia.
Other controlled trials of prepsychotic
intervention for schizophrenia are underway around the world, including one at Yale University, where investigators are comparing treatment with olanzapine and placebo.