Treatment Plan & Prognosis

Treatment Plan

Risk assessment:

• High risk: same-day assessment/crisis management
• Low risk: early intervention services
• Prodromal phase: treat as low risk if not urgent

Management:

• A specialist mental health referral is required
• No drug treatment without specialist assessment
• Individualised CBT +/- family intervention
• Art therapy for negative symptoms
• Secondary care is responsible for the first 12 months
• Primary care management after stabilisation

Medications:

First-generation antipsychotics:
• Haloperidol
• Chlorpromazine
• Levomepromazine

Second-generation antipsychotics:

• Aripiprazole
• Risperidone
• Quetiapine
• Olanzapine
• Clozapine (requires FBC monitoring)

Pregnancy/breastfeeding:

• Do not stop without specialist advice
• Breastfeeding is appropriate except with clozapine

Prognosis

Complications:

• Premature death
• Cardiovascular disease
• Diabetes
• Social functioning difficulties
• Substance misuse
• Cancers
• Infections (hepatitis C, TB, HIV)