APA Releases New Practice Guideline on Treatment of Patients with Schizophrenia

WASHINGTON, D.C., Sept. 1, 2020 – The American Psychiatric Association (APA) today released a new evidence-based practice guideline to enhance the treatment of patients with schizophrenia. Its goals are to reduce the mortality, morbidity and significant psychosocial and health consequences of this psychiatric condition.

An executive summary of the guideline is published in the American Journal of Psychiatry, available online today. The full guideline and related materials are available at psychiatry.org/psychiatrists/practice/clinical-practice-guidelines.

Schizophrenia is one of the top 20 causes of disability worldwide. The lifetime prevalence of schizophrenia is estimated at 0.7%, although findings vary depending on demographics and other variables. The disorder is also associated with increased mortality and a shortened lifespan.

“Schizophrenia is a disorder that can be debilitating for people who experience it, and it is more prevalent than many of us would presume. This new guideline offers psychiatrists an approach to help patients that incorporates effective, evidence-based treatments as well as our patients’ preferences and goals,” said APA President Jeffrey Geller, M.D., M.P.H. “We encourage all psychiatrists and others who are interested to review the recommendations, which were developed by experts in researching and treating this complicated disorder.”

he guideline recommends that patients with schizophrenia have a documented, comprehensive, and person-centered treatment plan that includes evidence-based nonpharmacological and pharmacological treatments. It includes:

Pharmacotherapy recommendations

• Antipsychotic medication with monitoring for effectiveness and side effects; continuation of medication for those whose symptoms have improved;
• Clozapine for patients with treatment-resistant schizophrenia or those with substantial risk of suicide or suicide attempts; and
• Long-acting injectable antipsychotics for those who prefer them.

Psychosocial Intervention recommendations

• Coordinated specialty care program for patients experiencing a first episode of psychosis; and
• Cognitive-behavioral therapy for psychosis, psychoeducation and supported employment services.

The guideline also recommends or suggests several treatment options for side effects associated with antipsychotic medication. The guideline was approved by the APA Board of Trustees at its Dec. 2019 meeting. It was developed using a systematic process that is intended to be consistent with the recommendations of the Institute of Medicine and the Council of Medical Specialty Societies. The guideline was written by the APA Practice Guideline Writing Group led by George Keepers, M.D., chair, and Laura Fochtmann, M.D., M.B.I., vice-chair.

American Psychiatric Association

The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 38,800 physician members specializing in the diagnosis, treatment, prevention and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information please visit www.psychiatry.org.

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