In this chapter, we will discuss recommendations for the pharmacological treatment of clinical high risk (CHR) symptoms. In addition to a brief summary of the current state of research on pharmacotherapy for CHR symptoms, we will focus on medication education, medication adjustment, and monitoring, as well as compliance. There are currently no official guidelines recommending pharmacological treatment for patients meeting CHR criteria, and CHR status alone is not an indication for medication. A symptom-based, cautious approach is advised, using low-dose atypical antipsychotics with a favorable side-effect profile. Any pharmacological treatment should be closely monitored by an experienced psychiatrist, and discontinuation should be gradual and carefully supervised.