What are The Schizophrenia Patient Outcomes Research Team (PORT) of the University of Maryland recommendations for the initial treatment of schizophrenia?

Updated: Mar 16, 2018
  • Author: Frances R Frankenburg, MD; Chief Editor: Glen L Xiong, MD  more...
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Answer

The Schizophrenia Patient Outcomes Research Team (PORT) of the University of Maryland recommended that any antipsychotic medication, with the exceptions of clozapine and olanzapine, can be used as first-line treatment for patients with schizophrenia who are experiencing their first episode of acute positive symptoms. [88]

According to a comprehensive review carried out by the Schizophrenia Patient Outcomes Research Team (PORT) of the University of Maryland, early treatment with any antipsychotic medication is associated with significant symptom reduction; first- and second-generation antipsychotics may have equivalent significant short-term efficacy. However, because of the adverse adverse-effect profile of clozapine and the significant metabolic risks associated with olanzapine, PORT advised that neither drug should be considered as a first-line treatment for first-episode schizophrenia. [88]

Noting that both responsiveness to treatment and sensitivity to adverse effects are greater in patients with first-episode schizophrenia than in those who have had multiple episodes, PORT recommended starting antipsychotic treatment for the former at doses lower than those recommended for the latter. An exception is quetiapine, which may not be effective in lower doses; in addition, low doses of aripiprazole or ziprasidone have not been evaluated in first-episode schizophrenia. [88]


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