First episode psychosis: early intervention strategies with second-generation antipsychotic medications

Schizophrenia is a debilitating chronic illness that has its onset in adolescence or the early years of adulthood. The benefit of early diagnosis and treatment has been acknowledged for decades, although facilitating the early identification of patients with schizophrenia remains a challenge. Research has demonstrated that many individuals are living with the symptoms of psychosis for prolonged periods in the community, and family physicians are well positioned to identify such patients. Community education is an important strategy, in that it increases the general awareness of psychotic illness and lessens the stigma of mental illness, eventually encouraging individuals to seek help. We review here some of the evidence indicating the benefit of early treatment, and describe the strategies to assist in the identification of patients with a first episode of schizophrenia and key treatment modalities available. Ultimately, there is a need for comprehensive, accessible healthcare including medications that have minimal side-effects and are effective.