Korean Treatment Guideline on Pharmacotherapy of Co-existing Symptoms and Antipsychotics-related Side Effects in Patients with Schizophrenia
10.16946/kjsr.2019.22.2.21
- Author:
Je Yeon YUN
1
;
Jung Suk LEE
;
Shi Hyun KANG
;
Beomwoo NAM
;
Seung Jae LEE
;
Seung Hwan LEE
;
Joonho CHOI
;
Chan Hyung KIM
;
Young Chul CHUNG
Author Information
1. Seoul National University Hospital, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Antipsychotics-related Side effects;
Co-existing symptoms;
Schizophrenia;
2019 Korean Medication Algorithm for Schizophrenia
- MeSH:
Antidepressive Agents;
Antipsychotic Agents;
Aripiprazole;
Benzodiazepines;
Cholinergic Antagonists;
Clinical Decision-Making;
Clozapine;
Consensus;
Depression;
Dihydroergotamine;
Drug Therapy;
Humans;
Injections, Intramuscular;
Metformin;
Naltrexone;
Propranolol;
Psychiatry;
Schizophrenia;
Serotonin Uptake Inhibitors;
Substance-Related Disorders;
Suicide;
Varenicline
- From:Korean Journal of Schizophrenia Research
2019;22(2):21-33
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES: The current study covers a secondary revision of the guidelines for the pharmacotherapy of schizophrenia issued by the Korean Medication Algorithm for Schizophrenia (KMAP-SCZ) 2001, specifically for co-existing symptoms and antipsychotics-related side-effects in schizophrenia patients. METHODS: An expert consensus regarding the strategies of pharmacotherapy for positive symptoms of schizophrenia, co-existing symptoms of schizophrenia, and side-effect of antipsychotics in patients with schizophrenia was retrieved by responses obtained using a 30-item questionnaire. RESULTS: For the co-existing symptoms, agitation could be treated with oral or intramuscular injection of benzodiazepine or antipsychotics; depressive symptoms with atypical antipsychotics and adjunctive use of antidepressant; obsessive-compulsive symptoms with selective serotonin reuptake inhibitors and antipsychotics other than clozapine and olanzapine; negative symptoms with atypical antipsychotics or antidepressants; higher risk of suicide with clozapine; comorbid substance abuse with use of naltrexone or bupropion/ varenicline, respectively. For the antipsychotics-related side effects, anticholinergics (extrapyramidal symptom), propranolol and benzodiazepine (akathisia), topiramate or metformin (weight gain), change of antipsychotics to aripiprazole (hyperprolactinemia and prolonged QTc) or clozapine (tardive dyskinesia) could be used. CONCLUSION: Updated pharmacotherapy strategies for co-existing symptoms and antipsychotics-related side effects in schizophrenia patients as presented in KMAP-SCZ 2019 could help effective clinical decision making of psychiatrists as a preferable option.
