Journal ArticleDOI
Pharmacotherapy of first-episode schizophrenia.
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TLDR
Early and effective treatment of schizophrenia has been associated with better long-term outcome and 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.Abstract:
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.read more
Citations
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Journal ArticleDOI
Effectiveness of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: an open randomised clinical trial
René S. Kahn,W. Wolfgang Fleischhacker,Han Boter,Michael Davidson,Yvonne Vergouwe,I. P. M. Keet,Mihai Dumitru Gheorghe,Janusz K. Rybakowski,Silvana Galderisi,Jan Libiger,Martina Hummer,Sonia Dollfus,Juan J. López-Ibor,Luchezar Hranov,Wolfgang Gaebel,Joseph Peuskens,Nils Lindefors,Anita Riecher-Rössler,Diederick E. Grobbee +18 more
TL;DR: This pragmatic trial suggests that clinically meaningful antipsychotic treatment of first-episode of schizophrenia is achievable, for at least 1 year, but it cannot conclude that second-generation drugs are more efficacious than is haloperidol, since discontinuation rates are not necessarily consistent with symptomatic improvement.
Journal ArticleDOI
Relationship Between Dopamine D2 Occupancy, Clinical Response, and Side Effects: A Double-Blind PET Study of First-Episode Schizophrenia
TL;DR: The study confirms that D(2) occupancy is an important mediator of response and side effects in antipsychotic treatment, and is consistent with a "target and trigger" hypothesis of antipsychotics action.
Journal ArticleDOI
World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, Part 1: Update 2012 on the acute treatment of schizophrenia and the management of treatment resistance
Alkomiet Hasan,Peter Falkai,Thomas Wobrock,Jeffrey A. Lieberman,Birte Glenthøj,Wagner F. Gattaz,Florence Thibaut,Hans-Jürgen Möller +7 more
TL;DR: These updated guidelines are based on a first edition of the World Federation of Societies of Biological Psychiatry Guidelines for Biological Treatment of Schizophrenia published in 2005 and provide evidence-based practice recommendations that are clinically and scientifically meaningful.
Journal ArticleDOI
Randomised controlled trial of cognitive-behavioural therapy in early schizophrenia: acute-phase outcomes.
Shôn Lewis,Nicholas Tarrier,Gillian Haddock,Richard P. Bentall,Peter Kinderman,David Kingdon,Ronald Siddle,Richard Drake,Julie Everitt,Karen Leadley,Andy Benn,Katy Grazebrook,Cliff Haley,Shahid Akhtar,Linda Davies,Steve Palmer,Brian Faragher,Graham Dunn +17 more
TL;DR: CBT shows transient advantages over routine care alone or supportive counselling in speeding remission from acute symptoms in early schizophrenia.
Journal ArticleDOI
World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 2: Long-term treatment of schizophrenia
Peter Falkai,Thomas Wobrock,Jeffrey A. Lieberman,Birte Glenthøj,Wagner F. Gattaz,Hans-Jürgen Möller,Wfsbp Task Force on Treatment Guidelines for Schizophrenia +6 more
TL;DR: These guidelines for the biological treatment of schizophrenia were developed by an international Task Force of the World Federation of Societies of Biological Psychiatry to reach a consensus on a series of practice recommendations that are clinically and scientifically meaningful based on the available evidence.
References
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Journal ArticleDOI
The Positive and Negative Syndrome Scale (PANSS) for Schizophrenia
TL;DR: Review of five studies involving the PANSS provided evidence of its criterion-related validity with antecedent, genealogical, and concurrent measures, its predictive validity, its drug sensitivity, and its utility for both typological and dimensional assessment.
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Positron Emission Tomographic Analysis of Central D1 and D2 Dopamine Receptor Occupancy in Patients Treated With Classical Neuroleptics and Clozapine: Relation to Extrapyramidal Side Effects
Lars Farde,Anna-Lena Nordström,Frits-Axel Wiesel,Stefan Pauli,Christer Halldin,Göran Sedvall +5 more
TL;DR: This finding indicates that neuroleptic-induced extrapyramidal syndromes are related to the degree of central D2 occupancy induced in the basal ganglia of drug-treated schizophrenic patients and demonstrates that clozapine is also "atypical" with respect to the central D1 occupancy in patients.
Journal ArticleDOI
Duration of psychosis and outcome in first-episode schizophrenia.
Antony Loebel,Jeffrey A. Lieberman,Jose Alvir,David Mayerhoff,Stephen Geisler,Sally Szymanski +5 more
TL;DR: Duration of psychosis before treatment may be an important predictor of outcome in first-episode schizophrenia, and is significantly associated with time to remission as well as with level of remission.
Journal ArticleDOI
Serotonin-dopamine interaction and its relevance to schizophrenia
Shitij Kapur,Gary Remington +1 more
TL;DR: Serotonergic modulation of dopaminergic function provides a viable mechanism for enhancing therapeutics in schizophrenia, but much remains unclear.
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A Canadian multicenter placebo-controlled study of fixed doses of risperidone and haloperidol in the treatment of chronic schizophrenic patients.
Guy Chouinard,Barry Jones,Gary Remington,D. Bloom,Donald Addington,G.W. MacEwan,Alain Labelle,Linda Beauclair,Wendy Arnott +8 more
TL;DR: It is suggested that risperidone, at the optimal therapeutic dose of 6 mg/day, produced significant improvement in both positive and negative symptoms without an increase in drug-induced parkinsonian symptoms and with a significant beneficial effect on tardive dyskinesia.