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Patients experiencing a first psychotic episode have high rates of extrapyramidal symptoms EPSs when treated with the doses of neuroleptics used in multiepisode or chronic schizophrenia. There is some evidence that lower doses may be equally, if not more, effective but less toxic in this population. Evidence increasingly suggests that early intervention with antipsychotic medications has a positive effect on treatment response and outcomes in patients with schizophrenia. In contrast, a delay in initiation of antipsychotic treatment is associated with slower and less significant symptomatic recovery and poorer overall outcomes. The first five years after onset appears to be the critical window where the greatest functional decline associated with the illness occurs, indicating that initiation of treatment during this period may be particularly beneficial.
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