Update – Schizophrenia

17 Jun Update – Schizophrenia

We are pleased to announce an update to our Schizophrenia treatment algorithm. All TreatGx users now have access to the updated algorithm which includes many exciting enhancements that will help health care providers select the safest and most effective medications for their patients with schizophrenia.

One of the major items of this update is the addition of the ability to sort antipsychotics by side effect profile. Recent guidelines indicate that side effect profiles should be taken into consideration when choosing an antipsychotic medication, in collaboration with the patient. The updated Schizophrenia algorithm includes a sorting function based on the side effect profiles detailed in these guidelines, providing clinicians with an easy-to-use tool to select an appropriate medication option.

Updates include:

• Personalized medication treatment options based on 2 main treatment strategies:
  • Standard therapy (which includes acute and maintenance therapy for schizophrenia)
  • Treatment-resistant schizophrenia
• Detailed side effect profiles for each antipsychotic, including the frequency of occurrence for many important adverse effects
• Ability to sort antipsychotics by side effect profile and listing options with a lower risk of causing the selected side effect first. These side effects include:
  • Extrapyramidal symptoms
  • Metabolic syndrome
  • Anticholinergic effect
  • Sedation
  • Seizures
  • Orthostasis
  • QTc Prolongation
  • Hyperprolactinemia
• Inclusion of more antipsychotics:
  • Brexpiprazole
  • Cariprazine
  • Iloperidone
  • Molindone
  • Thioridazine
  • Thiothixene

All medication doses in this algorithm are also personalized based on each patient’s genetics, kidney function, liver function, and other medications they may be taking.  Medication treatment options and dosing are based on the most up to date guidelines from the 2020 American Psychiatric Association Practice Guideline For The Treatment of Patients With Schizophrenia [1], the 2020 Evidence-based guidelines for the pharmacological treatment of schizophrenia: Updated recommendations from the British Association for Psychopharmacology Guideline [2] and the 2017 World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia – a short version for primary care [3].

References: 
1. American Psychiatric Association. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia. In: American Psychiatric Association Publishing; 2020.

2. Barnes TR, Drake R, Paton C, et al. Evidence-based guidelines for the pharmacological treatment of schizophrenia: Updated recommendations from the British Association for Psychopharmacology. Journal of psychopharmacology (Oxford, England). 2020;34(1):3-78.

3. Hasan A, Falkai P, Wobrock T, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia – a short version for primary care. Int J Psychiatry Clin Pract. 2017;21(2):82-90.