Some teenagers with low-risk first-episode psychosis might not need to take medication to reduce symptoms and improve functioning, Australian researchers say.

In a randomised controlled trial that the authors say challenges conventional wisdom on the need for initial anti-psychotic drug therapy, a specific group of patients improved with psychosocial intervention only.

In addition, 44 received either 1mg risperidone or 3mg paliperidone, while the remainder received a placebo.

The trial was limited to patients who were at low risk to themselves or others, had untreated psychosis for less than six months, had low levels of suicidality and depression, and were living in stable accommodation with social support.