Hostname: page-component-669899f699-ggqkh Total loading time: 0 Render date: 2025-04-25T02:04:50.669Z Has data issue: false hasContentIssue false
  • English
  • Français

The Use of Pharmacotherapy in the Prodrome of Schizophrenia

Published online by Cambridge University Press:  07 November 2014

Gary Remington  and
Chekkera Shammi
Get access Rights & Permissions [Opens in a new window]

Abstract

In treating schizophrenia there has been a shift in focus, with more attention being paid to early intervention based on the notion that effective treatment at this point can improve outcome. Most of this work has centred on pharmacotherapeutic interventions during the first psychotic break. More recently, attention has turned to the potential value of intervening even earlier, that is during the so-called “prodrome” that has been identified as predating the first psychotic break by as much as 4–5 years. We now have a limited number of published reports addressing this topic and these are reviewed here.

Type
Review Article
Information
CNS Spectrums , Volume 9 , Issue 8 , August 2004 , pp. 579 - 586
Copyright
Copyright © Cambridge University Press 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

REFERENCES

1. Kane, JM, Rifkin, A, Quitkin, F, Nayak, D, Ramos-Lorenzi, J. Fluphenazine vs placebo in patients with remitted, acute first-episode schizophrenia. Arch Gen Psychiatry. 1982;39:70–73.CrossRefGoogle ScholarPubMed
2. Gilbert, PL, Harris, MJ, McAdams, LA, Jeste, DV. Neuroleptic withdrawal in schizophrenic patients. A review of the literature. Arch Gen Psychiatry. 1995;52:173–188.CrossRefGoogle ScholarPubMed
3. Amminger, GP, Edwards, J, Brewer, WJ, Harrigan, S, McGorry, PD. Duration of untreated psychosis and cognitive deterioration in first-episode schizophrenia. Schizophr Res. 2002;54:223–230.CrossRefGoogle ScholarPubMed
4. Bottlender, R, Strauss, A, Moller, HJ. Impact of duration of symptoms prior to first hospitalization on acute outcome in 998 schizophrenic patients. Schizopkr Res. 2000;44:145–150.CrossRefGoogle ScholarPubMed
5. Drake, RJ, Haley, CJ, Akhtar, S, Lewis, SW. Causes and consequences of duration of untreated psychosis in schizophrenia. Br J Psychiatry. 2000;177:511–515.CrossRefGoogle ScholarPubMed
6. Malla, AK, Norman, RM, Manchanda, R et al. , One year outcome in first episode psychosis: influence of DUP and other predictors. Schizophr Res. 2002;54:231–242.CrossRefGoogle ScholarPubMed
7. Verdoux, H, Liraud, F, Bergey, C, Assens, F, Abalan, F, van Os, J. Is the association between duration of untreated psychosis and outcome confounded? A two year follow-up study of first-admitted patients. Schizophr Res. 2001;49:231–241.CrossRefGoogle ScholarPubMed
8. Wyatt, RJ, Green, MF, Tuma, AH. Long-term morbidity associated with delayed treatment of first admission schizophrenic patients: a re-analysis of the Camarillo State Hospital data. Psychol Med. 1997;27:261–268.CrossRefGoogle ScholarPubMed
9. Lieberman, JA. Pathophysiologic mechanisms in the pathogenesis and clinical course of schizophrenia. J Clin Psychiatry. 1999;60(suppl 12):9–12.Google ScholarPubMed
10. Lieberman, JA. Is schizophrenia a neurodegenerative disorder? A clinical and neurobiological perspective. Biol Psychiatry. 1999;46:729–739.CrossRefGoogle ScholarPubMed
11. Hafher, H, an der Heiden, W. Epidemiology of schizophrenia. Con J Psychiatry. 1997:42:139–151.Google Scholar
12. Yung, AR, McGorry, PD. The prodromal phase of first-episode psychosis: past and current conceptualizations. Schizophr Bull. 1996;22:353–370.CrossRefGoogle ScholarPubMed
13. Keshavan, MS, Carter, CS. First-episode schizophrenia: a phase-specific approach to management. Primary Psychiatry. 2000;7:43–50.Google Scholar
14. Lieberman, JA, Perkins, D, Belger, A et al. , The early stages of schizophrenia: speculations on pathogenesis, pathophysiology, and therapeutic approaches. Biol Psycruotry. 2001;50:884–897.CrossRefGoogle ScholarPubMed
15. DeGrazia, D. Ethical issues in early-intervention clinical trials involving minors at risk for schizophrenia. Schizophr Res. 2001;51:77–86.CrossRefGoogle ScholarPubMed
16. Cornblatt, BA, Lencz, T, Kane, JM. Treatment of the schizophrenia prodrome: is it presently ethical? Schizophr Res. 2001;51:31–38.CrossRefGoogle ScholarPubMed
17. McGlashan, TH. Psychosis treatment prior to psychosis onset: ethical issues. Schizophr Res. 2001;51:47–54.CrossRefGoogle ScholarPubMed
18. McGlashan, TH, Miller, TJ, Woods, SW. Pre-onset detection and intervention research in schizophrenia psychoses: current estimates of benefit and risk. Schizopkr Bull. 2001;27:563–570.CrossRefGoogle ScholarPubMed
19. McGorry, PD, Yung, A, Phillips, L. Ethics and early intervention in psychosis: keeping up the pace and staying in step. Schizophr Res. 2001;51:17–29.CrossRefGoogle ScholarPubMed
20. Fennig, S, Kovasznay, B, Rich, C et al. , Six-month stability of psychiatric diagnoses in first-admission patients with psychosis. Am J Psychiatry. 1994;151:1200–1208.Google ScholarPubMed
21. Munk-Jorgensen, P. The schizophrenia diagnosis in Denmark. A register-based investigation. Acta Psychiatr Scand. 1985;72:266–273.CrossRefGoogle Scholar
22. Lenz, G, Simhandl, C, Thau, K. Temporal stability and predictive validity of diagnostic criteria for schizophrenia [abstract]. Schizophr Res. 1992;6:170.Google Scholar
23. Addington, J. The prodromal stage of psychotic illness: observation, detection, or intervention? J Psychiatry Neurosd. 2003;28:93–97.Google ScholarPubMed
24. Yung, AR, Phillips, LJ, Yuen, HP et al. , Psychosis prediction: 12-month follow up of a high-risk (“prodromal”) group. Sduzophr Res. 2003;60:21–32.Google ScholarPubMed
25. Taylor, DM. Antipsychotics and QT prolongation. Acta Psychiatr Scand. 2003;107:85–95.CrossRefGoogle ScholarPubMed
26. Nasrallah, H. A review of the effect of atypical antipsychotics on weight. Psychone woendocrinology. 2003;28(suppl l):83–96.CrossRefGoogle ScholarPubMed
27. Henderson, DC. Atypical antipsychotic-induced diabetes mellitus: how strong is the evidence? CNS Drugs. 2002; 16:77–89.Google Scholar
28. Hoff, AL, Sakuma, M, Razi, K, Heydebrand, G, Csernansky, JG, DeLisi, LE. Lack of association between duration of untreated illness and severity of cognitive and structural brain deficits at the first episode of schizophrenia. Am J Psychiatry. 2000;157:1824–1828.CrossRefGoogle ScholarPubMed
29. Norman, RM, Townsend, L, Malla, AK. Duration of untreated psychosis and cognitive functioning in first-episode patients. Br J Psychiatry. 2001;179:340–345.CrossRefGoogle ScholarPubMed
30. Craig, TJ, Bromet, EJ, Fennig, S, Tanenberg-Karant, M, Lavelle, J, Galambos, N. Is there an association between duration of untreated psychosis and 24- month clinical outcome in a first-admission series? Am J Psychiatry. 2000;157:60–66.CrossRefGoogle Scholar
31. Hoff, AL, Sakuma, M, Wieneke, M, Horon, R, Kushner, M, DeLisi, LE. Longitudinal neuropsychological follow-up study of patients with first-episode schizophrenia. Am J Psychiatry. 1999;156:1336–1341.CrossRefGoogle ScholarPubMed
32. Robinson, DG, Woerner, M, McMeniman, M. Recovery in first episode schizophrenia. Schizophr Res. 2003;60(suppl):301.CrossRefGoogle Scholar
33. Woods, SW, Breier, A, Zipursky, RB et al. , Symptomatic and functional recovery from a first episode of schizophrenia or schizoaffective disorder. Am J Psychiatry. 2004;161:473–479.Google Scholar
34. Tsuang, MT, Stone, WS, Seidman, LJ et al. , Treatment of nonpsychotic relatives of patients with schizophrenia: four case studies. Biol Psychiatry. 1999;45:1412–1418.CrossRefGoogle ScholarPubMed
35. McGorry, PD, Yung, AR, Phillips, LJ et al. , Randomized controlled trial of interventions designed to reduce the risk of progression to first-episode psychosis in a clinical sample with subthreshold symptoms. Arch Gen Psychiatry. 2002;59:921–928.CrossRefGoogle Scholar
36. Cornblatt, B, Lencz, T, Correll, C, Author, A, Smith, C. Treating the prodrome: naturalistic findings from the RAP program. Acta Psychiatr Scand. 2002;106(suppl):44.Google Scholar
37. Cannon, TD, Huttunen, MO, Dahlstrom, M, Larmo, I, Rasanen, P, Juriloo, A. Antipsychotic drug treatment in the prodromal phase of schizophrenia. Am J Psychiatry. 2002;159:1230–1232.CrossRefGoogle ScholarPubMed
38. Tsuang, MT, Stone, WS, Faraone, SV. Understanding predisposition to schizophrenia: toward intervention and prevention. Can J Psychiatry. 2002;47:518–526.CrossRefGoogle ScholarPubMed
39. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
40. Buckley, PF.New antipsychotic agents: emerging clinical profiles. J Clin Psychiatry. 1999;60(suppl 1):12–17.Google ScholarPubMed
41. Waddington, JL, O'Callaghan, E. What makes an antipsychotic ‘atypical’? CNS Drugs. 1997;7:341–346.CrossRefGoogle Scholar
42. Remington, G, Shammi, CM, Sethna, R, Lawrence, R. Antipsychotic dosing patterns for schizophrenia in three treatment settings. Psychiatr Serv. 2001;52:96–98.CrossRefGoogle ScholarPubMed
43. Remington, G, Kapur, S, Zipursky, B. Pharmacotherapy of first episode psychosis. In: Miller, T, Mednick, SA, McGlashan, TH, Libiger, J, Johannessen, JO, eds. Early Intervention in Psychotic Disorders, vol 91. London, England: Kluwer Academic Publishers; 2001;167–180.CrossRefGoogle Scholar
44. Remington, GJ, Prendergast, P, Bezchlibnyk-Butler, KZ. Neuroleptic dosing in chronic schizophrenia: a 10-year follow-up. Can J Psychiatry. 1997;42:53–57.CrossRefGoogle ScholarPubMed
45. Kapur, S, Zipursky, RB, Jones, C, Remington, GJ, Houle, S. Relationship between dopamine D2 occupancy, clinical response, and side effects: a double-blind PET study of first-episode schizophrenia. Am J Psychiatry. 2000;157:514–520.CrossRefGoogle ScholarPubMed
46. Zhang-Wong, J, Zipursky, RB, Beiser, M, Bean, G. Optimal haloperidol dosage in first-episode psychosis. Can J Psychiatry. 1999;44:164–167.CrossRefGoogle ScholarPubMed
47. Lieberman, JA, Koreen, AR, Chakos, M et al. , Factors influencing treatment response and outcome of first-episode schizophrenia: implications for understanding the padiophysiology of schizophrenia. J Clin Psychiatry. 1996;57(suppl 9):5–9.Google ScholarPubMed
48. Aguilar, EJ, Keshavan, MS, Martinez-Quiles, MD, Hernandez, J, Gomez-Beneyto, M, Schooler, NR. Predictors of acute dystonia in first-episode psychotic patients. Am J Psychiatry. 1994;151:1819–1821.Google ScholarPubMed
49. Green, MF, Marder, SR, Glynn, SM et al. , The neurocognitive effects of low-dose haloperidol: a two-year comparison with risperidone. Biol Psychiatry. 2002;51:972–978.CrossRefGoogle ScholarPubMed
50. Leucht, S, Pitschel-Walz, G, Abraham, D, Kissling, W. Efficacy and extrapyramidal side-effects of the new antipsychotics olanzapine, quetiapine, risperidone, and sertindole compared to conventional antipsychotics and placebo. A meta-analysis of randomised controlled trials. Schizophr Res. 1999;35:51–68.CrossRefGoogle Scholar
51. Geddes, J, Freemantle, N, Harrison, P, Bebbington, P. Atypical antipsychotics in aBMJ. 2000;321:1371–1376.Google Scholar
52. Beasley, CM, Dellva, MA, Tamura, RN et al. , Randomised double-blind comparison of the incidence of tardive dyskinesia in patients with schizophrenia during long-term treatment with olanzapine or haloperidol. Br J Psychiatry. 1999;174:23–30.CrossRefGoogle ScholarPubMed
53. Emsley, R, the Risperidone Working Group. Risperidone in the treatment of first-episode psychotic patients: a double-blind multicenter study. Schizophr Bull. 1999;25:721–729.CrossRefGoogle ScholarPubMed
54. Peacock, L, Solgaard, T, Lublin, H, Gerlach, J. Clozapine versus typical anti-psychotics. A retro- and prospective study of extrapyramidal side effects. Psychopharmacology. 1996;124:188–196.CrossRefGoogle Scholar
55. Glazer, WM. Expected incidence of tardive dyskinesia associated with atypical antipsychotics. J Clin Psychiatry. 2000;61 (suppl 4):21–26.Google ScholarPubMed
56. Tollefson, GD, Beasley, CM Jr, Tamura, RN, Tran, PV, Potvin, JH. Blind, controlled, long-term study of the comparative incidence of treatment-emergent tardive dyskinesia with olanzapine or haloperidol. Am J Psychiatry. 1997;154:1248–1254.Google ScholarPubMed
57. Jeste, DV, Lacro, JP, Bailey, A, Rockwell, E, Harris, MJ, Caligiuri, MP. Lower incidence of tardive dyskinesia with risperidone compared with haloperidol in oldet patients. J Am Geriatr Soc. 1999;47:716–719.CrossRefGoogle Scholar
58. Jeste, DV, Okamoto, A, Napolitano, J, Kane, JM, Martinez, RA. Low incidence of persistent tardive dyskinesia in elderly patients with dementia treated with risperidone. Am J Psychiatry. 2000;157:1150–1155.CrossRefGoogle ScholarPubMed
59. Morrison, AP, Bentall, RP, French, P et al. , Randomised controlled trial of early detection and cognitive therapy fpr preventing transition to psychosis: study design and interim analysis of transition rate and psychological risk factors. Br J Psychiatry. 2002;181(suppl 3):S78–S84.CrossRefGoogle Scholar
60. Sackett, DL. The arrogance of preventive medicine. CMAJ. 2002;167:363–364.Google ScholarPubMed