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Acute effects of treatment for prodromal symptoms for people putatively in a late initial prodromal state of psychosis

Department of Psychiatry and Psychotherapy, University of Cologne, Germany

KAI-UWE KÜHN, MD and MICHAEL WAGNER, PhD

Department of Psychiatry and Psychotherapy, University of Bonn, Germany

FRAUKE SCHULTZE-LUTTER, PhD

Department of Psychiatry and Psychotherapy, University of Cologne, Germany

BIRGIT JANSSEN, MD

Department of Psychiatry and Psychotherapy, Heinrich-Heine-University, Düsseldorf, Germany

KURT MAURER, MD and HEINZ HÄFNER, PhD

Central Institute of Mental Health, Mannheim, Germany

WOLFGANG GAEBEL, MD

Heinrich-Heine-University, Düsseldorf, Germany

HANS-JÜRGEN MÖLLER, MD

Department of Psychiatry and Psychotherapy, University of Munich, Germany

WOLFGANG MAIER, MD

Department of Psychiatry and Psychotherapy, University of Bonn, Germany

JOACHIM KLOSTERKÖTTER, MD

Department of Psychiatry and Psychotherapy, University of Cologne, Germany

Correspondence: Stephan Ruhrmann, MD, Department of Psychiatry and Psychotherapy, University Hospital of the University of Cologne, Kerpener Strasse 62, 50924 Cologne, Germany. Email: stephan.ruhrmann{at}uk-koeln.de

Declaration of interest None. Funding detailed in Acknowledgements.

Background People in a putatively late prodromal state not only have an enhanced risk for psychosis but already suffer from mental and functional disturbances.

Aims To evaluate the acute effects of a combined supportive and antipsychotic treatment on prodromal symptoms.

Method Putatively prodromal individuals were randomly assigned to a needs-focused intervention without (n=59) or with amisulpride (n=65). Outcome measures at 12-weeks effects were prodromal symptoms, global functioning and extrapyramidal side-effects.

Results Amisulpride plus the needs-focused intervention produced superior effects on attenuated and full-blown psychotic symptoms, basic, depressive and negative symptoms, and global functioning. Main side-effects were prolactin associated.

Conclusions Coadministration of amisulpride yielded a marked symptomatic benefit. Effects require confirmation by a placebo-controlled study.