In patients experiencing a first episode of psychosis who misuse substances, what is the most effective intervention for improving patient outcomes?
No definite clinical implications may be made from the available
evidence. Generally, there is a consensus that more randomised
controlled trials (RCTs) of psychological interventions for
patients with early psychosis and concurrent substance abuse or
dependence are required. Some of the included studies also
highlighted the difficulties in delivering interventions to this
group of participants, so that this needs consideration in the
Regarding pharmaceutical interventions, no RCTs were included in
this BEST summary that exclusively included participants with
first-episode psychosis and substance use disorder. The authors
consistently noted that more RCTs, and new strategies, are needed
to treat first-episode participants with substance use disorder.
One author suggested that if clinicians are choosing between
olanzapine and respiridone, the decision should be based upon
factors other than symptom response and short-term substance
misuse, as both medications appear to have equal efficacy.
To view the full summary, click the Download Document
link to the right.