HealthDay News — Improper drug treatment is given to nearly 40% of people who suffer their first episode of schizophrenia, according to a new study published online in The American Journal of Psychiatry.

The study included 404 people who suffered a first episode of schizophrenia. They were seen at community treatment centers in 21 states. Of those patients, 159 received drug treatment that was inconsistent with recommendations for first-episode patients.

Some of the more common mistakes the researchers cited included: (1) prescribing more than one antipsychotic medication; (2) a higher-than-recommended dose of an antipsychotic; (3) the use of psychotropic medication other than an antipsychotic; (4) prescribing an antidepressant without justification; and (5) the use of the antipsychotic olanzapine, which is especially likely to cause major weight gain but was often prescribed at high doses.

“Academic research has found that optimal medication selection and dosing for first-episode patients differs from that for patients with longer illness durations,” study author Delbert Robinson, MD, a psychiatrist at the Zucker Hillside Hospital in Glen Oaks, New York, said in a journal news release. “The challenge to the field is to get this specialized knowledge to busy clinicians who are treating patients. 

“Our finding that treatment differed based upon patients’ insurance status suggests that in order to improve first-episode care we may also need to address treatment system issues,” he added.


Robinson DG, et al. Am J. Psychiatry. 2014; doi: 10.1176/appi.ajp.2014.13101355.