Editorial: Assessing the Predictive Characteristics of Second-Generation Antipsychotic Early Nonresponse in Youth With First-Episode Psychosis

• Published in: Journal of the American Academy of Child and Adolescent Psychiatry Vol. 61; no. 8; pp. 968 - 971
• Main Author: DelBello, Melissa P.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2022; Elsevier BV
• Subjects: Adherence; Adolescents; Antipsychotics; Clinical trials; Clozapine; Drugs; Efficacy; Patients; Psychosis; Psychotropic drugs; Remission; Remission (Medicine); Schizophrenia; Second generation; Teenagers; Youth
• ISSN: 0890-8567; 1527-5418
• DOI: 10.1016/j.jaac.2022.04.005

Identifying early predictors of response or nonresponse to medications in youth with first-episode psychosis is essential to optimize outcome. Specifically, longer duration of untreated psychosis is associated with less long-term improvement in youth.1 Therefore, identifying early predictors of nonresponse to medications is particularly important in patients with first-episode psychosis to minimize duration of untreated psychosis and avoid lengthy trials of ineffective and poorly tolerated medications. Additionally, medication response is associated with better adherence. A recent study of youth with first-episode psychosis reported that medication efficacy promotes adherence if it produces sustained remission of positive symptoms.2 Thus, early identification of effective medications is associated with better adherence and ultimately improves outcome. Conversely, characterizing early predictors of nonresponse to specific antipsychotics in patients with first-episode psychosis is also important because it might trigger a clinician to consider pharmacological options that are not typically considered early in the illness course (eg, clozapine).3