Acute psychotic episode

An acute psychotic episode can be a one-time occurrence, usually of sudden onset, or can occur repeatedly or may be the early phase of chronic psychosis. It can occur following a life event (e.g. loss, acute stress or trauma). In postpartum psychosis, the delusions centre on the mother-child relationship.

Before prescribing antipsychotic medication, consider the possibility of an underlying organic cause (see Acute confusional state (delirium)) or use of toxic substances.

Antipsychotic therapy is the same as that for chronic psychoses (risperidone or haloperidol) and should last at least 3 months. After 3 months, if the patient is stable, stop the treatment gradually over 4 weeks, monitoring for potential relapse.

For severe anxiety or agitation, a short-course anxiolytic or sedative treatment may be added to the antipsychotic treatment, at the beginning of treatment.