schizophrenia
SCHIZOPHRENIA
Treatment Guideline Chart
Schizophrenia is a devastating mental illness characterized by symptoms eg hallucinations, disorganized thinking, loss of goal-directed behaviors and deterioration in social role functioning.
Positive or psychotic symptoms are delusions, hallucinations, and distorted perceptions.
Negative symptoms include flat or blunted emotions, lack of motivation or energy, lack of pleasure or interest in things, and limited speech.
Disorganized symptoms are confused thinking, disorganized speech and behavior.
Cognitive symptoms include impairment in attention verbal fluency memory, and executive functioning.

Schizophrenia References

  1. Buckley PF, Noffsinger SG, Hrouda DR, et al. Treatment of psychotic patient who is violent. Psychiatr Clin North Am. 2003 Mar;26(1):231-272. PMID: 12683268
  2. Geddes J, Freemantle N, Harrison P, et al. Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis. BMJ. 2000 Dec;321(7273):1371-1376. PMID: 11099280
  3. Csernansky JG. Treatment of schizophrenia: preventing the progression of disease. Psychiatr Clin North Am. 2003 Jun;26(2):367-379. PMID: 12778839
  4. Emsley R, Oothuizen P. The new and evolving pharmacotherapy of schizophrenia. Psychiatr Clin North Am. 2003 Mar;26(1):141-163. PMID: 12683264
  5. Davis JM, Chen N, Glick ID. A meta-analysis of the efficacy of second-generation antipsychotics. Arch Gen Psychiatry. 2003 Jun;60(6):553-564. PMID: 12796218
  6. Lambert TJ, Castle DJ. Pharmacological approaches to the management of schizophrenia. Med J Aust. 2003 May;178(Suppl 9):S57-S61. PMID: 12720524
  7. Keck PE, McElroy SL. Aripiprazole: a partial dopamine D2 receptor agonist antipsychotic. Expert Opin Investig Drugs. 2003 Apr;12(4):655-662. PMID: 12665420
  8. Gunasekara NS, Spencer CM, Keating GM. Ziprasidone: a review of its use in schizophrenia and schizoaffective disorder. Drugs. 2002;62(8):1217-1251. PMID: 12010089
  9. Lindenmayer JP, Kanellopoulou I. Schizophrenia with impulsive and aggressive behaviors. Psychiatr Clin North Am. 2009 Dec;32(4):885-902. PMID: 19944890
  10. Miller AL, Hall CS, Crismon ML, et al. Texas Implementation of Medication Algorithms (TIMA) procedural manual: schizophrenia module. 2003 Jan:1-77. http://coordipsy.files.wordpress.com.
  11. Moore TA, Covell NH, Essock SM, et al. Real-world antipsychotic treatment practices. Psychiatr Clin North Am. 2007 Sep;30(3):401-416. PMID: 17720029
  12. Srisurapanont M, Maneeton B, Maneeton N. Quetiapine for schizophrenia. Cochrane Database Syst Rev. 2004;3:CD000967. PMID: 15106155
  13. Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for the Treatment of Schizophrenia and Related Disorders. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of schizophrenia and related disorders. Aust N Z J Psychiatry. 2005 Jan;39(1):001-30. PMID: 15660702
  14. Muench J, Hamer AM. Adverse effects of antipsychotic medications. Am Fam Physician. 2010 Mar;81(5):617-622. PMID: 20187598
  15. Schultz SK, Andreasen NC. Schizophrenia. The Lancet. 1999 Apr;353(9162):1425-1430. PMID: 10227239
  16. Tandon R. Schizophrenia. Conn's Current Therapy. 55th ed: Saunders, an imprint of Elsevier; 2003
  17. Pinals DA, Breier A. Schizophrenia. Tasman: Psychiatry. 1st ed: Saunders Company; 1997
  18. MedWorm http://www.medworm.com/rss/index.php/Psychiatry/172/ www.medworm.com/rss/medicalfeeds/specialities/Psychiatry-News.xml
  19. Behan C. Current approaches to the management of schizophrenia (Continuing Professional Development, Module 2). Irish Journal of Psychological Medicine. http://www.ijpm.ie. Sep 2009. Accessed 11 Aug 2010.
  20. Dixon L, Perkins D, Calmes C, et al. Guideline watch (September 2009): practice guideline for the treatment of patients with schizophrenia, in American Psychiatric Association Practice guidelines for the treatment of psychiatric disorders. Psychiatryonline. http://www.psychiatryonline.org. 2004.
  21. Nussbaum AM, Stroup TS. Paliperidone for the treatment of adults with schizophrenia (review). The Cochrane Collaboration. 2008.
  22. Ministry of Health Singapore. Schizophrenia. MOH (Singapore). http://www.moh.gov.sg. Feb 2003
  23. National Collaborating Centre for Mental Health. Schizophrenia: core interventions in the treatment and management of schizophrenia in primary and secondary care. NICE. http://www.nice.org.uk. 2009. Accessed 11 Aug 2010.
  24. American Psychiatric Association. Schizophrenia spectrum and other psychotic disorders. In: Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013:87-122.
  25. Hasan A, Falkai P, Wobrock T, et al. World Federation of Societies of Biological Psychiatry (WFBSP) guidelines for biological treatment of schizophrenia, part 1: update 2012 on the acute treatment of schizophrenia and the management of treatment resistance. World J Biol Psychiatry. 2012;13(5):318-378. http://www.wfsbp.org. Accessed 15 Apr 2015. PMID: 22834451
  26. Hasan A, Falkai P, Wobrock T, et al. World Federation of Societies of Biological Psychiatry (WFBSP) guidelines for biological treatment of schizophrenia, part 3: update 2015 management of special circumstances: depression, suicidality, substance use disorders and pregnancy and lactation. World J Biol Psychiatry. 2015;16(3):142-170. doi: 10.3109/15622975.2015.1009163. Accessed 15 Apr 2015. PMID: 25822804
  27. Taylor D, Paton C, Kapur S. The Maudsley Prescribing Guidelines in Psychiatry. 11th ed: Wiley-Blackwell; 2012:11-151.
  28. Jones MP, Nicholl D, Trakas K. Efficacy and tolerability of paliperidone ER and other oral atypical antipsychotics in schizophrenia. Int J Clin Pharmacol Ther. 2010 Jun;48(6):383-399. PMID: 20497747
  29. Nussbaum AM, Stroup TS. Paliperidone palmitate for schizophrenia (review). The Cochrane Collaboration. 2012.
  30. Mathews M, Tesar G, Fattal O, Muzina DJ. Schizophrenia and acute psychosis. In: Carrey WD. Current Clinical Medicine. Philadelphia, PA: The Cleveland Clinic Foundation; 2009. Accessed 25 Apr 2017:985-994.
  31. Wilson MP, Pepper D, Currier GW, et al. The psychopharmacology of agitation: consensus statement of the American Association for Emergency Psychiatry Project BETA Psychopharmacology Workgroup. West J Emerg Med. 2012 Feb;13(1):26-34. doi: 10.5811/westjem.2011.9.6866. PMID: 22461918
  32. Harvey PD. The clinical utility of lurasidone in schizophrenia: patient considerations. Neuropsychiatr Dis Treat. 2015;11:1103-1109. doi: 10.2147/NDT.S68417. PMID: 25995636
  33. Loebel A, Citrome L. Lurasidone: a novel antipsychotic agent for the treatment of schizophrenia and bipolar depression. BJPsych Bulletin. 2015;39(5):237-241. doi: 10.1192/pb.bp.114.048793. PMID: 26755968
  34. Norman R, Lecomte T, Addington D, et al. Canadian treatment guidelines on psychosocial treatment of schizophrenia in adults. Can J Psychiatry. 2017 Sep;62(9):617-623. doi: 10.1177/0706743717719894. PMID: 28703017
  35. Remington G, Addington D, Honer W, et al. Guidelines for the pharmacotherapy of schizophrenia in adults. Can J Psychiatry. 2017 Sep;62(9):604-616. doi: 10.1177/0706743717720448. PMID: 28703015
  36. Barnes TR, Drake R, Paton C, Cooper SJ, et al. Evidence-based guidelines for the pharmacological treatment of schizophrenia: updated recommendations from the British Association for Psychopharmacology. J Psychopharmacol. 2020 Jan;34(1):3-78. doi: 10.1177/0269881119889296. Accessed 18 Nov 2020. PMID: 31829775
  37. National Institute for Health and Care Excellence. Transcranial magnetic stimulation for auditory hallucinations. NICE. https://www.nice.org.uk. 23 Sep 2020.
  38. National Institute for Health and Care Excellence. Psychosis and schizophrenia in adults: prevention and management. NICE. https://www.nice.org.uk. 14 Feb 2014.
  39. Keepers GA, Fochtmann LJ, Anzia JM et al. The American Psychiatric Association practice guideline for the treatment of patients with schizophrenia. Am J Psychiatry. 2020 Sep;177(9):868-872. doi: 10.1176/appi.ajp.2020.177901. Accessed 15 Oct 2020. PMID: 32867516
  40. Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US). 2016 Jun.
  41. Bustillo B, Well E. Psychosocial interventions for schizophrenia. UpToDate. https://www.uptodate.com. 30 Apr 2019.
  42. Fischer BA, Buchanan RW. Schizophrenia in adults: Clinical manifestations, course, assessment, and diagnosis. UpToDate. https://www.uptodate.com. 3 Jun 2020.
  43. Galletly C, Castle D, Dark F, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders. Aust N Z J Psychiatry. 2016 May;50(5):410-472. doi: 10.1177/0004867416641195. PMID: 27106681
  44. Jibson MD. Second-generation antipsychotic medications: Pharmacology, administration, and side effects. UpToDate. https://www.uptodate.com. 2 Oct 2020.
  45. Jibson MD. First-generation antipsychotic medications: Pharmacology, administration, and comparative side effects. UpToDate. https:// www.uptodate.com. 11 May 2020.
  46. Marder S, Stroup TS. Pharmacotherapy for schizophrenia: Side effect management. UpToDate. https://www.uptodate.com. 22 Jul 2020.
  47. Moore G, Pfaff JA. Assessment and emergency management of the acutely agitated or violent adult. UpToDate. https://www.uptodate.com. 26 Aug 2020.
  48. Stroup TS, Marder S. Pharmacotherapy for schizophrenia: Acute and maintenance phase treatment. UpToDate. https:// www.uptodate.com. 21 Apr 2020.
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