Optimizing outcome with antipsychotic treatment in first-episode schizophrenia: balancing efficacy and side effects.


Journal Article (Review)

The initial tailoring of antipsychotic medication for an individual experiencing a first episode of psychosis (FEP) is a critical empirical process with potentially far-reaching consequences. This article reviews the results of randomized treatment trials of clinically available first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs) in individuals experiencing FEP, addressing these medications' relative therapeutic potentials and their proclivities to produce a range of unwanted side effects. The authors will argue that the best clinical long-term outcomes will be achieved with: 1) a "succeed-first" strategy of identifying those treatment-responsive individuals who will have a good response to neuroleptic threshold doses of well-tolerated FGAs (thereby avoiding weight gain, insulin resistance, and prolactin-induced changes in gender-specific physiology); and, 2) an early trial of clozapine in treatment-nonresponsive FEP patients.

Full Text

Duke Authors

Cited Authors

  • Freudenreich, O; McEvoy, JP

Published Date

  • October 2012

Published In

Volume / Issue

  • 6 / 3

Start / End Page

  • 115 - 121

PubMed ID

  • 23006236

Pubmed Central ID

  • 23006236

International Standard Serial Number (ISSN)

  • 1935-1232

Digital Object Identifier (DOI)

  • 10.3371/CSRP.6.3.3


  • eng

Conference Location

  • United States