Note: [] Address for correspondence: Stefan P. Kruszewski, Kruszewski & Associates, 133 Linglestown Road, Harrisburg, PA 17110, USA. Tel.: +1 (717) 234 2684; Fax: +1 (717) 234 2686; E-mail: skruszewski@spkmd.com.
Note: [] Dr. Stefan P. Kruszewski, MD, is a psychiatrist with extra distinctions in adolescent and geriatric psychiatry and addiction medicine. He is the founder and director of Stefan P. Kruszewski, MD & Associates, based in Harrisburg, Pennsylvania. Dr. Kruszewski is also the medical director of a mental health and substance abuse rehabilitation center in Harrisburg and has extensive experience in the evaluation of the safety and efficacy of psychoactive pharmaceuticals.
Note: [] Richard P. Paczynski, MD, is a neurologist in Harrisburg, Pennsylvania and an associate of Dr. Kruszewski.
Abstract: Pharmacologic intervention at the earliest stages of suspected psychotic illness is an intuitively appealing concept and a logical extension of the current approach to many other diseases of the central nervous system. Atypical antipsychotic agents (ATAPs) seem to be a reasonable choice for early intervention because existing pre-clinical data suggest that they have pharmacologic properties which might confer ‘neuroprotection’. However, a critical analysis of the results of structured clinical investigations which have explored the use of ATAPs for new-onset psychotic symptoms raises safety concerns and does not support pre-medication in this setting as a preventive strategy. Caution in current practice is therefore appropriate, underscoring the need for much additional clinical research.
Keywords: Schizophrenia prodrome, pre-medication, early psychosis, atypical antipsychotics, neuroprotection
