Prof. Benedicto Crespo-Facorro


Benedicto Crespo-Facorro Controversias Psiquiatria Barcelona
Talk Debate2. The controversy of first episodes treatment
Date Friday, April 21st, 2017
Time 17:15 - 17:45


Benedicto Crespo-Facorro is Full Professor of Psychiatry at the University of Cantabria, Spain, and section head of the University Hospital Marques de Valdecilla. He is main researcher of the psychiatry group in IDIVAL and CIBERSAM Group 26. Doctor in psychiatry from the Complutense University, Spain, he did his postdoctoral fellowship in schizophrenia research at the University of Iowa, USA. He is academician of the Royal Academy of Medicine of Cantabria and Director of care and research program of early stages of psychosis of Cantabria (PAFIP). His research interests encompass various lines of knowledge of schizophrenia; chasing the integration of results from clinical, genetic, neuroimaging, and basic research in people with a first episode of psychosis. He is Editorial Board Member of various European, Asian and American specialist journals. He is the main researcher of the National Plan projects since 2001 and researcher collaborator of European FP7 projects. He has received several scientific awards and recognitions: the annual Young Investigator Award from the American Neuropsychiatric Association (ANPA, 1997), Young Investigator Award of the International Congress on Schizophrenia Research (ICOSR, 2001), Reference Researcher in Psychiatry Award from of Spanish Society Biological Psychiatry (SEPB, 2006), Bank of Sabadell "National Award of Research in Biomedicine" (2007), Best scientific Article HU Marques de Valdecilla in 2013 and 2014. The period from 2000 to 2016, his research group has published 185 scientific papers published in leader psychiatry and medicine journals as Nature, Nature Genetics, Molecular psychiatry, American Journal of psychiatry, and JAMA psychiatry; His h factor is 40. He has directed 11 PhD theses at the University of Cantabria.


The efficacy of antipsychotic drugs in reducing the intensity of positive symptoms during outbreaks of the disease and in controlling the risk of relapse are supported by scientific evidence. However, many clinically relevant questions persist in clinical practice for which there is no consensus in their response. This reality leads us to the lack on many occasions of guidelines or clinical protocols that unify the optimal pharmacological and clinical approach of the first episodes of psychosis. The need to have a balance between clinical efficacy (reduction of symptoms), tolerability (short and long term), patient acceptability and preservation of functionality make us need clinical trials carried out in the real clinical world and that allow us to have a profile that encompass these aspects in an individualized way for each antipsychotic. Maintaining treatment or to suspend it after a certain time, replacing the treatment in the absence of response after a certain time without obvious clinical response, or evaluating the impact of the antipsychotics in the medium or long term on transient physical health parameters are also relevant aspects to consider in the area of clinical research in schizophrenia. I will try in my presentation, and based on the results of research carried out by our group, generate a debate on these controversies currently in force and provide transcendent information that emanates from clinical research and which I believe should be the subject of reflection and at the proper moment applied in the clinic in a protocolized and routine manner. Investigations on the effectiveness of the different antipsychotics most frequently used in our environment, its effect on relapse prevention, its long-term metabolic and endocrine adverse effects, the consequences of discontinuation of treatment in stabilized and normofunctioning patients will be presented and discussed.


[PDF] Mayoral-van Son J, et al. (2016). Clinical outcome after antipsychotic treatment discontinuation in functionally recovered first-episode nonaffective psychosis individuals: a 3-year naturalistic follow-up study. J Clin Psychiatry. 2016 Apr;77(4):492-500. doi: 10.4088/JCP.14m09540.

[PDF] Pérez-Iglesias R, et al. (2013). Course of weight gain and metabolic abnormalities in first treated episode of psychosis: the first year is a critical period for development of cardiovascular risk factors. Int J Neuropsychopharmacol. 2014 Jan;17(1):41-51. doi: 10.1017/S1461145713001053. Epub 2013 Oct 8.

[PDF] Crespo-Facorro B, et al. (2013). Aripiprazole, Ziprasidone and Quetiapine in the treatment of first-episode nonaffective psychosis: A 12-week randomized, flexible-dose, open-label trial. Schizophr Res. 2013 Jul;147(2-3):375-82. doi: 10.1016/j.schres.2013.04.014. Epub 2013 May 1.

[PDF] Crespo-Facorro B, et al. (2011). Long-term (3-year) effectiveness of haloperidol, risperidone and olanzapine: results of a randomized, flexible-dose, open-label comparison in first-episode nonaffective psychosis. Psychopharmacology (Berl). 2012 Jan;219(1):225-33. doi: 10.1007/s00213-011-2392-3. Epub 2011 Jul 7.

[web] Crespo-Facorro B, et al. (2016). Current Data on and Clinical Insights Into the Treatment of First Episode Nonaffective Psychosis: A Comprehensive Review. Neurol Ther. 2016 Dec; 5(2): 105–130.