Nearly 40% of people with first-episode psychosis in community-based mental health clinics might benefit from medication treatment changes, according to a recent study funded by the National Institute of Mental Health (NIMH).

Researchers have found that many patients experiencing first-episode psychosis do not receive medications compliant to the recommended guidelines that stress low-dose antipsychotics and strategies to minimize side effects that may contribute to drug discontinuation.

The RAISE Early Treatment Program team evaluated 404 patients aged 15–40 with first-episode psychosis who presented for treatment at 34 community-based clinics. A total of 159 patients (39.4%) were identified that may benefit from medication changes.

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Of the 159 patients:

  • 8.8% were prescribed higher-than-recommended doses of antipsychotics;
  • 23.3% were prescribed more than one antipsychotic;
  • 36.5% were prescribed an antipsychotic and an antidepressant (without a clear need established);
  • 10.1% were prescribed psychotropic medications without an antipsychotic; and
  • 1.2% were prescribed stimulants.

In addition, about one-third of these patients were prescribed olanzapine which is not recommended for first-episode patients.

Results of the study indicate a need for increased awareness of first episode-specific medication practices at community facilities. The study authors recommend more education for those prescribing medication for patients with first-episode psychosis.

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