Psychosis--a need for preemptive intervention?

With the advent of newer antipsychotic medications with fewer side-effects both clinicians and patients may be more willing to take early preemptive measures in treating psychotic disorders. We present a case report of use of pharmacotherapeutic intervention in an individual with either possible prodromal symptoms of schizophrenia or a subthreshold disorder. This case presented to us with the ethical dilemma inherent in treating a patient with subthreshold disorder. The options were either watchful waiting or preemptive treatment. In this case the patient was very distressed by his symptoms and had requested treatment with medications. Indeed, treatment has resulted in the remission of his symptoms and restored him to his previous level of functioning.