engleski

Comparison of Recommendations on Psychopharmacotherapy from Guidelines for Treatment of Schizophrenia

The aim of this article was to analyse and compare recommendations from guidelines for treatment of schizophrenia on psychopharmacotherapy of schizophrenia. The guidelines were analysed and compared regarding the initiatiation of antipsychotic treatment, the first choice antipsychotic in the first episode of schizophrenia, the daily dosage of antipsychotic in the first episode of schizophrenia, initiation of treatment with a single antipsychotic, introduction of clozapine in therapy, continuous dosing strategies or intermittent-dose strategies, medications in case of nonadherence, recommendations in case of treatment resistance, and initiation of antidepressant treatment. The investigated guidelines recommend that the treatment of psychotic episode should start as soon as possible, and that atypical antipsychotics (except clozapine) should be the first line of treatment during first episode of schizophrenia. The recommended daily dosages are between 300 and 1000 mg chlorpromazine equivalents for the first- generation antipsychotics in the treatment of an acute symptom episode for a minimum of 6 weeks, whereby the minimum effective dose should be used. Treatment should be initiated and continued with a single antipsychotic, except during short periods of overlap in the case of switching, and in the cases of treatment resistance. Guidelines recommend clozapine as treatment of choice for treatment-resistant schizophrenia. Targeted, intermittent dosage maintenance strategies should not be used routinely in lieu of continuous dosage regimens because of the increased risk of symptom worsening or relapse. In case of nonadherence long-acting injectable antipsychotic medication should be considered. Antidepressants may be added as an adjunct to antipsychotics when syndromal criteria for major depressive episode are met. In conclusion, the investigation showed vast similarities between recommendations from the five investigated guidelines for treatment of schizophrenia, with more differences in the extent of recomendations regarding particular investigated treatment issues.

Comparison of Recommendations on Psychopharmacotherapy

nije evidentirano