Antipsychotic Medication for Early-Episode Schizophrenia

Extract

Background

Long-term treatment with antipsychotic medications in early-episode schizophrenia spectrum disorders is common, but their short- and long-term effects on the illness are unclear. There have been numerous suggestions that people with early episodes of schizophrenia appear to respond differently than those with multiple prior episodes. The number of episodes may moderate response to drug treatment.

Objectives

To assess the effects of antipsychotic medication treatment on people with early-episode schizophrenia spectrum disorders.

Search Strategy

We searched the Cochrane Schizophrenia Group register (July 2006) as well as references of included studies. We contacted authors of studies for further data.

Selection Criteria

We included randomized clinical trials (RCTs) with a majority of first- and second-episode acute schizophrenia spectrum disorders comparing initial antipsychotic medication treatment with placebo, milieu, or psychosocial treatment.

Data Collection and Analysis

Working independently, we critically appraised records from 681 studies, of which 6 met inclusion criteria. When possible, we calculated risk ratios (RRs) and their 95% confidence intervals (CIs) for dichotomous data and weighted mean differences for continuous data. We calculated numbers needed to treat/harm (NNT/NNH) where appropriate.