What are the recommended first-line pharmacological treatments for managing psychosis in adults?

Recommended first-line pharmacological treatments for managing psychosis in adults involve the use of oral antipsychotic medication. NICE guidelines do not recommend a preference for one antipsychotic drug over another due to similar efficacy among available options, except for clozapine, which is reserved for treatment-resistant cases after inadequate response to two other antipsychotics. The choice of antipsychotic should be individualized, considering the person's clinical response, side effects, and previous medication history. Treatment should start at the lower end of the licensed dose range and be titrated slowly upwards. A therapeutic trial of 4 to 6 weeks at an optimum dose is recommended to assess effectiveness. Monitoring for side effects and physical health is essential throughout treatment, especially during the first 12 months or until stabilization. Psychological interventions such as cognitive behavioural therapy (CBT) should be offered alongside medication.