title: First-episode schizophrenia. A window of opportunity for optimizing care and outcomes.
abstract: The pernicious course of schizophrenia has spurred efforts to identify and effectively treat this condition as early as possible. This assertive therapeutic stance is supported by epidemiologic data suggesting a substantial time lag between onset of illness and therapeutic intervention, and by neurobiologic data suggesting that brain changes present in first-episode psychosis are comparable to those in chronic schizophrenia. The proposal that atypical antipsychotic medications may prevent illness deterioration and/or be a restorative intervention is an appealing, but as yet unproven, hypothesis. Major challenges to maximizing treatment outcomes in first-episode schizophrenia include optimizing timing and effectiveness of pharmacologic interventions, service coordination, and access to care. We present data on the onset and presentation of first-episode schizophrenia and emerging findings about the neurobiology of first episodes, review nonpharmacologic and pharmacologic management, and summarize clinical research data on use of atypical antipsychotics in first-episode patients.
authors.affiliation: Department of Psychiatry, Medical College of Georgia, Augusta 30912, USA. pbuckley@mail.mcg.edu
authors.forename: Peter E
authors.initials: PE
authors.lastname: Buckley
authors.forename: Denise
authors.initials: D
authors.lastname: Evans
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use; D001921:Brain / Q000033:anatomy & histology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D010349:Patient Compliance; D011613:Psychotherapy; D012559:Schizophrenia / Q000175:diagnosis* / Q000628:therapy*; D012565:Schizophrenic Psychology
chemical_list: D014150:Antipsychotic Agents