Objective: To present and evaluate the latest findings of studies pertaining to the pharmacological and alternative treatment of individuals at ultra-high risk (UHR) for psychosis.
Methodology: A title or abstract appeared to describe a study eligible for inclusion; the full article was obtained and examined to assess its relevance. The PUBMED search terms in the title used were psychosis, schizophrenia, "ultra-high risk," "clinical high risk," "at risk mental state," intervention, efficacy, effectiveness, management, treatment, and prevention. The combined search strategies yielded over 100 abstracts but, after an analysis of the abstracts, 97 full-text articles were reviewed. Finally, 35 articles were included.
Results: Antipsychotics that have been tried to date are amisulpride, aripiprazole, olanzapine, perospirone, risperidone, and ziprasidone. Although most studies included small groups, the baseline symptoms improved after pharmacological treatment. However, the antipsychotic effect of treatment with antipsychotics in UHR groups was insufficient to confirm positive results. In the long-term follow-up of UHR groups, more than 30% of studied individuals remained in the high-risk group and had clinically significant symptoms and difficulties.
Conclusion: If antipsychotics are to be used, atypical antipsychotics should be selected; starting with a low dose, and the treatment response and side effects should be periodically evaluated, while administration should last for an appropriately limited period of time. In addition to antipsychotics, use of antidepressants, nutrients/supplements including omega-3, and alternative drugs should be considered.
Key words: Psychosis, psychiatric symptoms, alternative treatments.
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