Psychofarmaca: pleidooi voor een voorzichtig beleid bij vroege psychose

Abstract

Psychopharmaceuticals: a plea for cautious management in early psychosis. From the holistic approach in VRINT (Early psychosis intervention team), a psychotic episode is regarded as an existential crisis in which both biological and psychosocial factors play a role and interact with each other. Non-pharmacological treatments are indispensable and preferred. However, antipsychotics can have an important role and be even lifesaving in certain circumstances. Therefore, in this article 3 questions are explored: How long before prescribing antipsychotics? How long should they be prescribed and is medication tapering possible? Are antipsychotics neuroprotective or rather harmful? Based on the scientific literature regarding antipsychotics as well as their own experience, the authors conclude that they do have their place in treating early psychosis, but they should be prescribed with the necessary caution, since antipsychotics are not harmless products. Treatment with antipsychotics should always consist of administering the lowest possible dose with a minimum of side effects. The decision to start treatment with antipsychotics and the correct adjustment of dosage should always be done in consultation with the person in crisis and his or her family. After a first psychotic episode, medication tapering can be considered, but the tapering off must be properly supervised over a sufficiently long period of time. After all, a full long-term recovery is pursued, whereby the person with psychosis can take control of his or her own life.