Thus, our focus is

on identifying the optimal intervention during each prodromal stage. Data from the RAP program concur with the McGorry and McGlashan groups in that our prodromal population is treatment-seeking, highly symptomatic at baseline, and generally benefits from intervention.52 Overall, the conversion rate within the RAP program across subjects with follow-up of at least 6 months is 20%. Consistent with our recruitment strategy and focus on the very early stages of the prodrome, our conversion rate is at the low end of the spectrum. However, when looked at more closely as a function of the RAP theoretical model, the pattern of clinical deterioration Inhibitors,research,lifescience,medical for the 97 subjects who, to date, have been followed for at least 1 year (mean follow-up Inhibitors,research,lifescience,medical 2.4 years) is highly consistent

with our developmentally based expectations. These results are presented in (Figure 2). Figure 2. Preliminary outcome. Within each box are included those subjects who received that classification at study entry and who also have 1 year of follow-up. AG-014699 manufacturer Arrows represent outcome as of a 1 June 2004 cutoff date. CHR-: clinical high risk-negative; CHR+mod: Inhibitors,research,lifescience,medical … Within each box are included those subjects who received that classification (ie, CHR-, CHR+mod, etc) at study entry and who also have at least 1 year of followup. Arrows represent outcome as of a 1 June 2004 cutoff date, though only the final outcome is represented (ie, intermediate shifts not shown). This preliminary longitudinal data provide Inhibitors,research,lifescience,medical some very early support for our developmental model indicating that rates of conversion will increase as subjects progress across prodromal stages from CHR- to SLR This figure also

presents the rates of broadly defined clinical Inhibitors,research,lifescience,medical deterioration from any given prodromal stage to a more severe one. As indicated by the figure, frequency of clinical deterioration shows a gradual increase from CHR- (14%) to CHR+mod (22%) to CHR+sev (30%) to SLP (50%). Naturalistic findings indicate that early treatment may be more complex than typically assumed, in that APs are not necessarily first-line choice in best-standards practice. For Sitaxentan those participants in the CHR+ category (which are comparable to the prodromal groups treated by both the McGorry and McGlashan groups), psychiatrists in the RAP program prescribed AD medication as often as AP medication. Furthermore, those on ADs generally did as well as those on APs (all SGAPs),52 This finding has led to initiation of a 16-week, double-blind, double-dummy study of an SGAP (risperidone) versus a typically used AD (sertraline), which is currently underway. Goals of the project are to determine the efficacy of the two classes of medication on symptom reduction and to determine if there is a differential rate of conversion between the groups.