, Volume 63, Issue 21, pp 2265–2283 | Cite as

Pharmacological Management of First-Episode Schizophrenia and Related Nonaffective Psychoses

  • Daniel W. Bradford
  • Diana O. Perkins
  • Jeffrey A. LiebermanEmail author
Therapy in Practice


Schizophrenia is a severe mental illness characterised by abnormalities of thought and perception that affects 1–2% of the population. Patients who experience a first episode of schizophrenia should be treated early and optimally with antipsychotic agents to lessen the morbidity of the initial episode and possibly improve the course of the illness. Positive psychotic symptoms remit in the majority of patients who are treated with adequate trials of antipsychotic medications, but most relapse within 1 year. Non-adherence is strongly related to the likelihood of recurrence of symptoms. Innovative programmes that integrate early intervention, psychosocial treatments and atypical antipsychotic pharmacotherapy show promise in improving outcomes.

The available research supports the use of antipsychotic medications early in the first-episode of schizophrenia and for at least 1 year after remission of positive symptoms. Antidepressants, benzodiazepines and mood stabilisers have roles in the acute and maintenance phases of treatment for some patients. Atypical antipsychotics represent a great advance in the treatment of first-episode schizophrenia with strong evidence for greater tolerability with equal or better therapeutic efficacy. Future research will further define their roles in treatment and hopefully identify targets for prevention of first-episode schizophrenia.


Schizophrenia Clozapine Atypical Antipsychotic Antipsychotic Medication Antipsychotic Treatment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This work was supported by the National Institute of Mental Health grants 1 K23 MH01905, 2T32MH019111 and MH64065, the Silvio O. Conte Center for the Neuroscience of Mental Disorders and by the Foundation of Hope of Raleigh (NC). The authors have a significant financial interest in or affiliation with one or more of the following: Bristol-Myers Squibb, Eli Lilly, Pfizer, Otsuka, AstraZeneca, Janssen, Aventis, GlaxoSmithKline and Repligen.


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Copyright information

© Adis Data Information BV 2003

Authors and Affiliations

  • Daniel W. Bradford
    • 1
  • Diana O. Perkins
    • 1
  • Jeffrey A. Lieberman
    • 1
    Email author
  1. 1.Thad and Alice Eure Distinguished Professor of PsychiatryUniversity of North Carolina School of Medicine, 7025 Neurosciences HospitalChapel HillUSA

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