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 and 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:

11 Apr 2014 08:46

Publisher DOI:

10.1097/YCO.0b013e32835dcc2a

PubMed ID:

23364281

Web of Science ID:

000314397400012

URI:

https://boris.unibe.ch/id/eprint/14634 (FactScience: 221707)

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