Nowe wytyczne leczenia schizofrenii w Ameryce

[Bright Angel]

Amerykańskie Towarzystwo Psychiatryczne zaktualizowało wytyczne leczenia schizofrenii.


Initial Assessment and Treatment Plan

The initial assessment of a patient with a possible schizophrenia-spectrum disorder should include an assessment of patient symptoms; patient preferences and goals for treatment; patient symptom and trauma history; patient tobacco and substance use; psychosocial and cultural circumstances; and risk for suicide attempt. A physical and cognitive assessment should also be performed.
The initial assessment should use a quantitative measure to determine symptom severity and impairment level.
Patient treatment plans should be comprehensive, well-documented, and incorporate evidence-based nonpharmacological and pharmacological treatments.

Pharmacotherapy

Patients with schizophrenia should receive an antipsychotic medication. During treatment, patients should be closely monitored for drug efficacy and adverse events.
Patients who improve with antipsychotic treatment should continue to receive an antipsychotic medication.
Patients with treatment-resistant schizophrenia may best benefit from clozapine.
Patients with high risk for suicide attempts may best benefit from clozapine treatment over other antipsychotic medications.
Patients with acute dystonia associated with antipsychotic treatment should receive an anticholinergic medication.
Patients with moderate to severe tardive dyskinesia associated with antipsychotic treatment should receive treatment with a reversible inhibitor of the vesicular monoamine transporter 2 (VMAT2).

Psychosocial Treatment

Patients presenting with first episode psychosis should be treated in a coordinated specialty care program.
Patients with schizophrenia should be treated with cognitive behavioral therapy for psychosis (CBTp).
Patients with schizophrenia should receive psychoeducation.
Patients with schizophrenia should receive employment support services.
Patients with a history of difficulty engaging in treatment should receive community-based services that enhance compliance.

(ang.):
https://www.psychiatryadvisor.com/home/ ... zophrenia/