{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:09:29Z","timestamp":1792066169903,"version":"4.4.0"},"reference-count":122,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010414","name":"Health Research Board","doi-asserted-by":"publisher","award":["APRO-2023-005"],"award-info":[{"award-number":["APRO-2023-005"]}],"id":[{"id":"10.13039\/100010414","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Australian Research Training Program scholarship RANZCP Foundation Partners PhD scholarship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early intervention in first-episode psychosis (FEP) is critical for long-term outcomes with antipsychotic medicines among the primary treatment options. However, existing clinical practice guidelines (CPGs) do not provide sex-specific recommendations, despite females experiencing distinct vulnerabilities to antipsychotic side-effects. In particular, hyperprolactinemia and cardiometabolic side-effects are associated with substantial subjective distress and potential long-term physical health risks for females across the reproductive lifespan. We aimed therefore to develop a CPG on the preferred antipsychotic medicines for females experiencing FEP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>An international multidisciplinary panel, including experts-by-experience, used the GRADE-ADOLOPMENT process and AGREE II framework to adapt existing FEP guidelines for adults and adolescents. Key health questions were developed through stakeholder consultation and literature review. Critically important patient outcomes were prioritized, and evidence was synthesized on side-effect profiles, with recommendations agreed by consensus. The guideline algorithm was field-tested and externally reviewed by experts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Results<\/jats:title>\n                    <jats:p>Prolactin-elevation and cardiometabolic side-effects were prioritized in antipsychotic medicine selection for females. Medicines with higher risks\u2014first-generation antipsychotics, olanzapine, quetiapine, risperidone, paliperidone, and amisulpride\u2014are not recommended first-line. Aripiprazole is recommended as the preferred first-choice due to its consistently favorable prolactin and cardiometabolic profile. Alternative options with low or low-to-medium risk profiles are recommended for adults and adolescents, supported by shared decision-making tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This is the first CPG addressing antipsychotic choice for females with FEP. By prioritizing critically important patient outcomes and lived experience, the guideline supports safer, sex-sensitive prescribing for females that may improve treatment acceptability, adherence, and equity in psychosis care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/schbul\/sbag023","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T12:46:20Z","timestamp":1770209180000},"source":"Crossref","is-referenced-by-count":6,"title":["Clinical Practice Guideline on the Choice of First Antipsychotic Medicine for Females Experiencing a First-Episode of Psychosis"],"prefix":"10.1093","volume":"52","author":[{"given":"Caroline","family":"Hynes-Ryan","sequence":"first","affiliation":[{"name":"Pharmacy Department And Research and Innovation Hub, St John of God University Hospital , Dublin A94 FH92 ,","place":["Ireland"]},{"name":"School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences , Dublin D02 V951 ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dolores","family":"Keating","sequence":"additional","affiliation":[{"name":"Pharmacy Department And Research and Innovation Hub, St John of God University Hospital , Dublin A94 FH92 ,","place":["Ireland"]},{"name":"School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences , Dublin D02 V951 ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0821-1489","authenticated-orcid":false,"given":"Aoife","family":"Carolan","sequence":"additional","affiliation":[{"name":"Pharmacy Department And Research and Innovation Hub, St John of God University Hospital , Dublin A94 FH92 ,","place":["Ireland"]},{"name":"School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences , Dublin D02 V951 ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bodyl","family":"Brand","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Oxford , Oxford OX3 7JX ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Dazzan","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London , SE5 8AB ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Gaughran","sequence":"additional","affiliation":[{"name":"National Psychosis Unit, South London and Maudsley NHS Foundation Trust , London BR3 3BX ,","place":["United Kingdom"]},{"name":"Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, SE5 8AF ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Hahn","sequence":"additional","affiliation":[{"name":"Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto , Toronto, ON, M5 S1A8 ,","place":["Canada"]},{"name":"Schizophrenia Division, Centre for Addiction and Mental Health , Toronto, ON, M5T 1R8 ,","place":["Canada"]},{"name":"Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto , Toronto, ON, M5T1R8 ,","place":["Canada"]},{"name":"Department of Pharmacology and Toxicology, Temerty Faculty of Medicine University of Toronto , ON, M5S 1A8 ,","place":["Canada"]},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, DK-2200 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4890-3506","authenticated-orcid":false,"given":"Sean","family":"Halstead","sequence":"additional","affiliation":[{"name":"Metro South Addiction and Mental Health Service , Brisbane, QLD 4109 ,","place":["Australia"]},{"name":"Faculty of Medicine, University of Queensland , Brisbane, QLD 4006 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie Mae","family":"Harrington","sequence":"additional","affiliation":[{"name":"Spunout , Dublin D02 T883 ,","place":["Ireland"]},{"name":"Youth Med. 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