Current Concepts: Diagnosis and Early Management of Acute Psychosis

If the patient has an active support system of family and friends, a stable place to live, and a rapid response to medication, outpatient treatment is sometimes possible. The goal of initial treatment is to reduce or eliminate the cardinal features of psychosis without producing unnecessary or unacceptable side effects. The intramuscular route gives a more rapid and reliable blood level and clinical response and also permits a better initial estimate of the optimal dosage. In manic-depressive illness, lithium carbonate may be more effective than antipsychotics and cause fewer complications; in a psychosis with complex partial seizures, anticonvulsants such as carbamazepine may be useful.