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Treatments for childhood and early-onset schizophrenia

What is childhood and early-onset schizophrenia?

Childhood-onset schizophrenia is defined as schizophrenia with onset prior to the age of 13 years, and early-onset schizophrenia describes schizophrenia onset between the ages of 13 and 17 years.

What is the evidence for pharmaceutical treatments for childhood and early-onset schizophrenia?

Compared to placebo, moderate to high quality evidence suggests medium-sized improvements in overall symptoms with olanzapine, risperidone, or paliperidone, and small improvements with quetiapine, aripiprazole, or asenapine. For positive symptoms, there were medium-sized improvements with olanzapine, risperidone, or asenapine, and small improvements with quetiapine, aripiprazole, or paliperidone. For negative symptoms, there were small to medium-sized improvements with aripiprazole, asenapine, molindone, olanzapine and risperidone. For social functioning, there were small to medium-sized improvements with aripiprazole, asenapine paliperidone and risperidone. Only quetiapine improved depression.

Moderate quality evidence suggests less use of benzodiazepines, less corrected QT, and less total bilirubin with second generation antipsychotics compared to placebo. However, antipsychotics are associated with more weight gain (particularly olanzapine and quetiapine), movement side effects (particularly paliperidione, ziprasidone, risperidone, and aripiprazole), somnolence, low or high prolactin levels, high triglycerides, high alanine aminotransferase, and high uric acid.

Compared to first generation antipsychotics in general, moderate quality evidence suggests a small to medium-sized benefit of second generation antipsychotics for global and mental state. Compared to low dose antipsychotics, moderate to high quality evidence suggests greater improvement in global state with standard dose antipsychotics, although there are more side effects with standard doses.

Also see the Course and Outcomes childhood onset topic, and the psychosocial treatments for childhood and early-onset schizophrenia topic.

 

July 2017

Page last updated: 2:22  7 September 2017

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