Robert Heinssen and Thomas Insel of the National Institute of Mental Health argue in Schizophrenia Bulletin that the balance of evidence does not support early intervention in psychosis.
“Promising results have been reported for cognitive-behavioral therapy, alone or in combination with family therapy, and omega-3 fatty acids,” they write. “Available data do not support antipsychotic medications as a first-line treatment for [clinical high risk] patients.” Most of the studies have been marred by poor trial designs, they argue.
Insel elaborates on his thoughts in his own blog.
Preventing the Onset of Psychosis: Not Quite There Yet (Heinssen, Robert K. and Insel, Thomas R. Schizophrenia Bulletin. First published online: November 11, 2014. doi: 10.1093/schbul/sbu161)
Can We Prevent Psychosis? (Directors Blog, National Institute of Mental Health, November 20, 2014)