Gary Remington1,2, Donald Addington3,4, William Honer5, Zahinoor Ismail4,6, Thomas Raedler7, Michael Teehan8. 1. 1 Departments of Psychiatry and Psychological Clinical Science, University of Toronto, Toronto, Canada. 2. 2 Schizophrenia Division, Continuing Care and Recovery Program, Centre for Addiction and Mental Health (CAMH), Toronto, Canada. 3. 3 Department of Psychiatry, University of Calgary, Calgary, Canada. 4. 4 Hotchkiss Brain Institute and Matheson Centre for Mental Health Research and Education, Calgary, Canada. 5. 5 Department of Psychiatry, University of British Columbia, Vancouver, Canada. 6. 6 Department of Psychiatry, University of Calgary, Calgary, Canada. 7. 7 Psychopharmacology Research Unit, Department of Psychiatry, University of Calgary, Calgary, Canada. 8. 8 Department of Psychiatry, Dalhousie University, Halifax, Canada.
Abstract
OBJECTIVE: The present guidelines address the pharmacotherapy of schizophrenia in adults across different stages, phases, and symptom domains. METHOD: Guidelines were developed using the ADAPTE process, which takes advantage of existing guidelines. Six guidelines were identified for adaptation, with recommendations extracted from each. For those specific to the pharmacotherapy of schizophrenia in adults, a working group selected between guidelines and recommendations to create an adapted guideline. RESULTS: Recommendations can be categorized into 6 areas that include 1) first-episode schizophrenia, 2) acute exacerbation, 3) relapse prevention and maintenance treatment, 4) treatment-resistant schizophrenia, 5) clozapine-resistant schizophrenia, and 6) specific symptom domains. For each category, recommendations are made based on the available evidence, which is discussed and linked to other established guidelines. CONCLUSIONS: In most cases, evidence-based recommendations are made that can be used to guide current clinical treatment and decision making. Notably, however, there is a paucity of established evidence to guide treatment decision making in the case of clozapine-resistant schizophrenia, a subsample that represents a sizable proportion of those with schizophrenia.
OBJECTIVE: The present guidelines address the pharmacotherapy of schizophrenia in adults across different stages, phases, and symptom domains. METHOD: Guidelines were developed using the ADAPTE process, which takes advantage of existing guidelines. Six guidelines were identified for adaptation, with recommendations extracted from each. For those specific to the pharmacotherapy of schizophrenia in adults, a working group selected between guidelines and recommendations to create an adapted guideline. RESULTS: Recommendations can be categorized into 6 areas that include 1) first-episode schizophrenia, 2) acute exacerbation, 3) relapse prevention and maintenance treatment, 4) treatment-resistant schizophrenia, 5) clozapine-resistant schizophrenia, and 6) specific symptom domains. For each category, recommendations are made based on the available evidence, which is discussed and linked to other established guidelines. CONCLUSIONS: In most cases, evidence-based recommendations are made that can be used to guide current clinical treatment and decision making. Notably, however, there is a paucity of established evidence to guide treatment decision making in the case of clozapine-resistant schizophrenia, a subsample that represents a sizable proportion of those with schizophrenia.
Authors: Robert A Rosenheck; John H Krystal; Robert Lew; Paul G Barnett; Louis Fiore; Danielle Valley; Soe Soe Thwin; Julia E Vertrees; Matthew H Liang Journal: N Engl J Med Date: 2011-03-03 Impact factor: 91.245
Authors: G Fond; O Godin; L Boyer; F Berna; M Andrianarisoa; N Coulon; L Brunel; E Bulzacka; B Aouizerate; D Capdevielle; I Chereau; T D'Amato; C Dubertret; J Dubreucq; C Faget; S Leignier; C Lançon; J Mallet; D Misdrahi; C Passerieux; R Rey; A Schandrin; M Urbach; P Vidailhet; P M Llorca; F Schürhoff; M Leboyer Journal: Eur Arch Psychiatry Clin Neurosci Date: 2018-05-28 Impact factor: 5.270
Authors: David D Kim; Alasdair M Barr; Lulu Lian; Jessica W Y Yuen; Diane Fredrikson; William G Honer; Allen E Thornton; Ric M Procyshyn Journal: NPJ Schizophr Date: 2021-05-25