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Swedish Council on Health Technology Assessment (SBU): SBU Systematic Review Summaries [Internet].
Conclusions Pharmacological treatments
- For people with schizophrenia better medical treatment can save lives. The SGA drugs clozapine, olanzapine and risperidone have better effects on psychotic symptoms than FGA drugs. Adverse effects differ between different the SGA drugs and are generally dose dependent. Pharmaceutical treatment options are generally cost effective, but there are few studies comparing the cost-effectiveness between individual SGA drugs.
- For people with treatment resistant schizophrenia, clozapine is the SGA drug with best effect on psychotic symptoms. Clozapine reduces the risk for suicidal behavior and may, at the same time, reduce the risk for drug and alcohol abuse. However, approximately 1% of those being treated with clozapine develop agranulocytosis (a substantial decrease in white blood cells) which increases the risk of infection and can be life threatening. Clozapine and olanzapine can cause substantial weight gain, especially when the treatment is started for the first time. Those being treated with Risperdone run a higher risk of developing severe movement disorders such as extrapyramidal symptoms and tardive dyskinesia, in comparison to those taking other SGA drugs.
- It is important that treatment plans address risk behaviours such as smoking, alcohol and drug abuse, low physical activity, and unbalanced diet in persons with schizophrenia.
- It is estimated that a person with schizophrenia will live 20 years less than the general population, in part due to the increased rates for suicide, coronary diseases and lifestyle diseases.
- The scientific evidence supports the view that the perspectives and views of patients and those closest to them should be taken into consideration when psychiatric treatment is planned. It is important to not underestimate the opportunities that shared decision making may provide. Maintaining a good relationship, based on mutual respect, between patient and health care providers, is essential when caring for people with schizophrenia. People with schizophrenia also need their contact with their health care providers to be stable, and should be involved in the planning of their own care plan. Effective communication between all of those involved, including the patient, care givers, friends and family, is of great importance.
- Patients, as well as their friends and relatives, and health care professionals, agree that pharmacological treatment is necessary but incomplete. Having sound relationships between the person with schizophrenia and their friends, their family and their care givers is particularly important for recovery. Any support that helps these individuals build or maintain their social network is valuable. People with schizophrenia, and to some extent their families and friends, also need active help combating discrimination and social isolation.
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- NLM CatalogRelated NLM Catalog Entries
- Review An open, large, 6-month naturalistic study of outcome in schizophrenic outpatients, treated with olanzapine.[Hum Psychopharmacol. 2011]Review An open, large, 6-month naturalistic study of outcome in schizophrenic outpatients, treated with olanzapine.Krzystanek M, Krupka-Matuszczyk I. Hum Psychopharmacol. 2011 Jan; 26(1):81-5. Epub 2011 Feb 9.
- Review [Hepatic tolerance of atypical antipsychotic drugs].[Encephale. 2002]Review [Hepatic tolerance of atypical antipsychotic drugs].Dumortier G, Cabaret W, Stamatiadis L, Saba G, Benadhira R, Rocamora JF, Aubriot-Delmas B, Glikman J, Januel D. Encephale. 2002 Nov-Dec; 28(6 Pt 1):542-51.
- [Use of atypical antipsychotics in Charles Perrens psychiatric hospital (Bordeaux) analysis of prescribing practices for Amisulpride, Clozapine, Olanzapine and Risperidone].[Encephale. 2002][Use of atypical antipsychotics in Charles Perrens psychiatric hospital (Bordeaux) analysis of prescribing practices for Amisulpride, Clozapine, Olanzapine and Risperidone].Bret P, Bonnet F, Bret MC, Jaffré A. Encephale. 2002 Jul-Aug; 28(4):329-42.
- Randomized controlled trial of effect of prescription of clozapine versus other second-generation antipsychotic drugs in resistant schizophrenia.[Schizophr Bull. 2006]Randomized controlled trial of effect of prescription of clozapine versus other second-generation antipsychotic drugs in resistant schizophrenia.Lewis SW, Barnes TR, Davies L, Murray RM, Dunn G, Hayhurst KP, Markwick A, Lloyd H, Jones PB. Schizophr Bull. 2006 Oct; 32(4):715-23. Epub 2006 Mar 15.
- [Drawing up guidelines for the attendance of physical health of patients with severe mental illness].[Encephale. 2009][Drawing up guidelines for the attendance of physical health of patients with severe mental illness].Saravane D, Feve B, Frances Y, Corruble E, Lancon C, Chanson P, Maison P, Terra JL, Azorin JM, avec le soutien institutionnel du laboratoire Lilly. Encephale. 2009 Sep; 35(4):330-9. Epub 2009 Jul 9.
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