Treatment of adolescents with early-onset schizophrenia spectrum disorders: in search of a rational, evidence-informed approach

Schimmelmann, Benno G.; Schmidt, Stefanie J.; Carbon, Maren; Correll, Christoph U. (2013). Treatment of adolescents with early-onset schizophrenia spectrum disorders: in search of a rational, evidence-informed approach. Current opinion in psychiatry, 26(2), pp. 219-230. Hagerstown, Md.: Lippincott Williams & Wilkins 10.1097/YCO.0b013e32835dcc2a

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Purpose of review: We aimed to review literature on the efficacy and tolerability of psychosocial and psychopharmacological interventions in youth with early-onset schizophrenia spectrum disorders (EOS). A rationale for pragmatic psychopharmacology in EOS, including dosing, switching and adverse effect monitoring and management, is provided.

Recent findings: Three randomized controlled trials (RCTs) over the last 8 years demonstrated benefits of psychosocial interventions (i.e. psychoeducation, cognitive remediation, cognitive behavioural therapy) for EOS without clear advantages of one psychosocial treatment over another. Six large, placebo-controlled, short-term RCTs over the last 4 years demonstrated that aripiprazole, olanzapine, paliperidone, quetiapine and risperidone, but not ziprasidone, were superior to placebo. Except for clozapine's superiority in treatment-refractory EOS, efficacy appeared similar across studied first-generation and second-generation antipsychotics, but tolerability varied greatly across individual agents.

Summary: Antipsychotics are efficacious in the treatment of EOS. Given the lack of efficacy differences between antipsychotics (except for clozapine for treatment-refractory EOS), we propose that tolerability considerations need to guide choice of antipsychotics. Further and longer-term efficacy and effectiveness studies are urgently needed that should also explore pharmacologic and nonpharmacologic augmentation strategies.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > University Psychiatric Services > University Hospital of Child and Adolescent Psychiatry and Psychotherapy 04 Faculty of Medicine > University Psychiatric Services > University Hospital of Child and Adolescent Psychiatry and Psychotherapy > Research Division
UniBE Contributor:	Schimmelmann, Benno Karl Edgar, Schmidt, Stefanie Julia
Subjects:	100 Philosophy > 150 Psychology 600 Technology > 610 Medicine & health
ISSN:	0951-7367
Publisher:	Lippincott Williams & Wilkins
Language:	English
Submitter:	Myriam Pyrlik
Date Deposited:	04 Oct 2013 14:36
Last Modified:	05 Dec 2022 14:11
Publisher DOI:	10.1097/YCO.0b013e32835dcc2a
PubMed ID:	23364281
Web of Science ID:	000314397400012
URI:	https://boris.unibe.ch/id/eprint/14634 (FactScience: 221707)