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Quality prescribing in early psychosis: key pharmacotherapy principles
James G Scott1,2,3, Gemma McKeon1,2, Eva Malacova1
1QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.
Objective:
To present a practical, easy-to-implement clinical framework designed to support evidence-based quality prescribing for people with early psychosis.
Method:
Identification and explanation of key principles relating to evidence-based pharmacotherapy for people with early psychosis. These were derived from the literature, practice guidelines and clinical experience.
Results:
Key principles include (1) medication choice informed by adverse effects; (2) metabolic monitoring at baseline and at regular intervals; (3) comprehensive and regular medication risk-benefit assessment and psychoeducation; (4) early consideration of long-acting injectable formulations (preferably driven by informed patient choice); (5) identification and treatment of comorbid mood disorders and (6) early consideration of clozapine when treatment refractory criteria are met.
Conclusions:
Current prescribing practices do not align with the well-established evidence for quality pharmacotherapy in early psychosis. Adopting evidence-based prescribing practices for people with early psychosis will improve outcomes.
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