Dealing with Early-Onset Schizophrenia and the Role of Lurasidone: An Expert Opinion

Compared to schizophrenia in adults, Early Onset Schizophrenia (EOS) features diagnostic, clinical, and therapeutic peculiarities that are the subject of ongoing discussion among psychiatrists and neuropsychiatrists. This article presents the outcomes of a meeting and a series of virtual roundtable discussions among specialists who validated practical recommendations for the diagnosis and management of EOS in light of recent literature. The identification of risk factors and prodromal symptoms, as well as the differentiation of EOS from other psychiatric conditions, is crucial for early detection. Timely identification enables the implementation of appropriate psycho-behavioural and pharmacological interventions and supports close monitoring of the developmental trajectories associated with EOS. The collaboration between the different professionals who deal with EOS patients and a therapeutic approach that allows a normal cognitive, sexual, and psychophysical development makes it possible to ensure the therapeutic alliance necessary for the optimal management of the disease over time. In a scenario that is complicated by negative prognostic factors, such as the late recognition of the disease, comorbid and latent psychiatric conditions, the increasingly widespread use of substances among adolescents, and a poor therapeutic adherence often due to antipsychotics side effects, a growing body of literature emphasizes the advantages of lurasidone in the treatment of EOS. Compared to other pharmacological agents commonly used in schizophrenia, lurasidone has been shown to intervene comprehensively and effectively against the positive and negative symptoms of EOS, with manageable side effects and the preservation of a good QoL.