Treating a first episode of psychosis

Treating a first episode of psychosis

If professionals think that you have psychosis, they should offer you therapy and antipsychotic medication. Therapy works better with antipsychotic medication. However, if you (or your parents or carers) decide that you would rather not take this, professionals should see you regularly and arrange a time (usually within a month) to discuss again whether you would like to start medication.

You should be offered CBT with a type of therapy involving your family called family intervention. Family intervention should last between 3 months and a year and include at least 10 meetings. CBT involves at least 16 meetings with a healthcare professional without your family or carers. The healthcare professional should make sure that everyone is happy with how the therapy is going.

Some treatments described may not be suitable for you, depending on your exact circumstances. If you think that your treatment or care does not match this advice, talk to your healthcare team.

If you wish to try treatments not usually prescribed by healthcare professionals (called 'complementary therapies'), you should discuss these with your healthcare team. The team should advise you whether these are safe, helpful and whether they are likely to affect your prescribed medication and therapy.

Taking antipsychotic medication

Your healthcare professional should give you all the details of the possible different medications, how they can help and their benefits and side effects. They should involve you and your parents or carers in deciding which medication to take. They should ask which side effects you would most like to avoid.

If you choose a newer (second generation) antipsychotic medication and are considering olanzapine, your healthcare professional should tell you that you are likely to gain more weight with olanzapine than with other medications of this type, and that gaining weight is likely to happen soon after you start treatment.

You should not be prescribed antipsychotic medication by your GP unless they have had advice from a consultant psychiatrist with training in child and adolescent mental health.

Before starting medication, your healthcare professional should measure your weight, height, waist and hips, pulse and blood pressure, and give you blood tests to check your general health. They should make sure that you know it's especially important to keep healthy by eating well and taking regular exercise. They may check your heart (using an electrocardiogram).

Your healthcare professional should see you regularly while you are taking antipsychotic medication, especially at first. They should check whether the medication is helping and whether there are side effects. They should also check your general health and if there are problems taking the medication.

The medication may take some time to work (up to about 6 weeks), but if after a time it is not helping or you have distressing side effects, your healthcare team may offer a different antipsychotic medication. It may take a while to find the right medication, but your healthcare team should guide you through this. They should not offer you more than one antipsychotic at the same time, except for short periods if the medication is changed.

Your healthcare professional should review your medication each year to see if it is still helping. They should advise you that drinking alcohol, smoking or taking other drugs could stop the antipsychotic medication working and make your symptoms worse.

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