No convincing evidence suggests that atypical antipsychotic medications are superior to typical medications for the treatment of adolescents with psychosis .
However , atypical antipsychotic medications may be more acceptable to young people because fewer symptomatic adverse effects are seen in the short term .
Little evidence is available to support the superiority of one atypical antipsychotic medication over another , but side effect profiles are different for different medications .
Treatment with olanzapine , risperidone and clozapine is often associated with weight gain .
Aripiprazole is not associated with increased prolactin or with dyslipidaemia .
Adolescents may respond better to st and ard-dose as opposed to lower-dose risperidone , but for aripiprazole and ziprasidone , lower doses may be equally effective .
BACKGROUND Schizophrenia often presents in adolescence , but current treatment guidelines are based largely on studies of adults with psychosis .
Over the past decade , the number of studies on treatment of adolescent-onset psychosis has increased .
The current systematic review collates and critiques evidence obtained on the use of various atypical antipsychotic medications for adolescents with psychosis .
OBJECTIVES To investigate the effects of atypical antipsychotic medications in adolescents with psychosis .
We review ed in separate analyses various comparisons of atypical antipsychotic medications with placebo or a typical antipsychotic medication or another atypical antipsychotic medication or the same atypical antipsychotic medication but at a lower dose .
Cognitive remediation therapy (CRT) for young early onset patients with schizophrenia: An exploratory randomized controlled trial
BACKGROUND Schizophrenia with an onset in adolescence is known to be associated with a poorer outcome and cognitive difficulties . These impairments have an impact on quality of life and represent treatment targets . Cognitive remediation therapy ( CRT ) attempts to improve cognitive deficits by teaching information processing strategies through guided mental exercises . The objective of this study is to evaluate the efficacy of CRT in alleviating cognitive deficits compared to treatment as usual and explore the mediating and moderating effects of cognitive improvement . METHOD Single-blind r and omized controlled trial with two groups , one receiving CRT ( N21 ) and the other st and ard care ( N19 ) assessed at baseline , 3 months ( post therapy ) and follow-up ( 3 months post therapy ) . Participants were recruited from specialist inpatient and community mental health services and were young patients with recent onset schizophrenia ( average age of 18 ) and evidence of cognitive and social behavioural difficulties . The intervention was individual cognitive remediation therapy delivered over a period of 3 months with at least three sessions per week . The main outcome measures were cognition ( memory , cognitive flexibility and planning ) and secondary outcomes ( symptoms , social contacts and self-esteem ) . RESULTS Compared to st and ard care , CRT produced significant additional improvements in cognitive flexibility as measured by the Wisconsin Card Sort Test ( WCST ) . Therapy moderated the effects of improved planning ability on symptoms such that improvements only had a beneficial effect when they were achieved in the context of CRT .  Improvements in cognition in all domains had a direct effect on social functioning and improvements in WCST had a direct effect on overall symptom improvement . CONCLUSIONS Cognitive remediation therapy can contribute to the improvement in WCST even in adolescents . The changes in cognitive outcomes also contributed to improvements in functioning either directly or solely in the context of CRT . Evidence of the mediator and moderator effects of cognitive changes should lead to more effective therapy development
No convincing evidence suggests that atypical antipsychotic medications are superior to typical medications for the treatment of adolescents with psychosis .
However , atypical antipsychotic medications may be more acceptable to young people because fewer symptomatic adverse effects are seen in the short term .
Little evidence is available to support the superiority of one atypical antipsychotic medication over another , but side effect profiles are different for different medications .
Treatment with olanzapine , risperidone and clozapine is often associated with weight gain .
Aripiprazole is not associated with increased prolactin or with dyslipidaemia .
Adolescents may respond better to st and ard-dose as opposed to lower-dose risperidone , but for aripiprazole and ziprasidone , lower doses may be equally effective .
BACKGROUND Schizophrenia often presents in adolescence , but current treatment guidelines are based largely on studies of adults with psychosis .
Over the past decade , the number of studies on treatment of adolescent-onset psychosis has increased .
The current systematic review collates and critiques evidence obtained on the use of various atypical antipsychotic medications for adolescents with psychosis .
OBJECTIVES To investigate the effects of atypical antipsychotic medications in adolescents with psychosis .
We review ed in separate analyses various comparisons of atypical antipsychotic medications with placebo or a typical antipsychotic medication or another atypical antipsychotic medication or the same atypical antipsychotic medication but at a lower dose .