Randomized controlled trial of antipsychotic and cognitive therapy in young people at ultra-high risk of psychosis

Presentation First Author: 
Patrick McGorry

Background Cognitive therapy (CT) and/or low dose antipsychotic administered to Individuals deemed as being at Ultra High Risk (UHR) for psychotic disorder may prevent or delay the onset of full blown illness. However it is unclear which of these treatments are most effective. Method In order to examine these issues, we conducted a randomized controlled trial of CT plus risperidone (CT+Risp); CT plus placebo (CT+Plac); and supportive therapy plus placebo (Supp+Plac) in UHR young people. Results 12-month transition rates were: CT+Risp, 10.7%; CT+Plac, 9.6%; ST+Plac, 21.8%. There were no statistically significant differences between the three groups in transition rates. Symptoms and functioning in all three groups improved over the course of the trial, Discussion The unexpectedly low, and essentially equivalent, transition rates in all three groups fail to support the use of antipsychotic medications as a first-line therapy for UHR patients. Other treatments such as CT, supportive therapy and neuroprotective agents including fish oil need further examination. Ethical issues associated with labeling of UHR people as such and types and duration of treatment also need further discussion

Conference Name: 
Presentation Date: 
January, 2013
Additional Authors: 
Alison Yung, Paul Amminger, Gregor Berger, Andrew Thompsom, Lisa Phillips, Barnaby Nelson, Shona Francey, Hok Pan Yuen, Patrick McGorry
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