Principles of treating psychoses including schizophrenia in children

The principles of treating psychoses including schizophrenia in children are similar to the principles of treating adults and young people; however:

• multidisciplinary care should ideally be provided by a specialist service with practitioners experienced in treating psychotic disorders in children, with close collaboration with the child’s parents or services (eg educational, juvenile, forensic) as appropriate
• there are fewer data on psychotropic use or other interventions in children. Antipsychotics have similar efficacy in children as they do in adults, but ziprasidone is not effective for children with schizophrenia
• children appear to be at greater risk of adverse effects including extrapyramidal adverse effects, effects due to elevated blood prolactin concentration, and weight gain
• prepubertal psychosis is associated with a poor long-term prognosis
• additional support should be provided when a child transitions to another service (eg a youth service), to facilitate effective transfer of care and prevent relapse.