THE PHARMACOLOGIC TREATMENT OF SCHIZOPHRENIA: STATUS REPORT

Despite the availability of numerous medications to treat schizophrenia the proportion of patients who either experience residual psychotic symptoms, are considered treatment resistant, relapse despite medication, or have meaningful challenges with treatment acceptance or adherence remains very high. At the same time there is renewed debate about medication dose reduction and discontinuation. As the field has tried to promulgate the implementation of evidenced based medicine and measurement-based care, we continue to witness limited and inconsistent utilization of evidenced based treatments such as long -acting formulations of antipsychotic medications or clozapine.The introduction of muscarinic agonists represents an important advance in providing alternatives to the direct dopamine receptor antagonism which has been the long-standing basis for antipsychotic drug development. We now must understand the full implications of such alternatives and the degree to which they are associated with different or better outcomes.

Learning Objective 1: To bring the audience up to date on the data regarding a new class of medicines-the muscarinic agonists.

Learning Objective 2: To review data on the underutilization of evidenced based treatments and discuss potential reasons for this problem.

References

McCutcheon RA, Taylor D, Rubio J, et al. Does Slow and Steady Win the Race? Rates of Antipsychotic Discontinuation, Antipsychotic Dose, and Risk of Psychotic Relapse. Schizophr Bull. 2024 Apr 30;50(3):513-520. Takeuchi H, Siu C, Remington G, et al. Does relapse contribute to treatment resistance? Antipsychotic response in first-vs. second-episode schizophrenia. Neuropsychopharmacology. 2019 May;44(6):1036-1042.