Table 1.
APM is recommended across the guidelines in the initial treatment of acute schizophrenic episode
| Society | Guideline title | Statement |
|---|---|---|
| WFSBP 2012 | WFSBP Guidelines for Biological Treatment of Schizophrenia, Part 1: update 2012 on the acute treatment of schizophrenia and the management of treatment resistance | -APM should be the first-line treatment -APP should be a strategy of last resort for TRS |
| NICE 2014 | NICE: psychosis and schizophrenia in adults | -No routine APP except for short periods -Need to check serum level of AP |
| RANZCP 2016 | RANZCP clinical practice guidelines for the treatment of schizophrenia and related disorders | -APP should be in variant form of transition process for AP switching |
| American Psychiatric Association (2020) | The American Psychiatric Association Practice Guideline for the Treatment of Patients with schizophrenia | -Clozapine trial should be considered in the first place. -APP maybe helpful for emergency visits and rehospitaliza-tion rates as compared to monotherapy. -No evidence that APP is any more harmful than using APM, beyond the common side effects from each drug |
| CPA 2017 | Guidelines for the Pharmacotherapy of Schizophrenia in Adults | -Clozapine should be first considered if two different APMs fail -There is insufficient evidence to make any specific recom-mendation for APP |
| BAP 2020 | Evidence-based guidelines for the pharmacological treatment of schizophrenia: updated recommendations from the BAP | -APP should be used with a closely monitored and short-term trial after a lack of response to several adequate trials of APM -No more availability of other evidence-based treatments in-cluding clozapine failure |
| TMAP 2007 | The TMAP antipsychotic algorithm for schizophrenia: 2006 update | -Clozapine APP trial should be placed before initiation of APP with non-clozapine AP |
WFSBP, World Federation of Societies of Biologic Psychiatry; NICE, the National Institute for Health and Care Excellence; RANZCP, Royal Australian and New Zealand College of Psychiatrists; CPA, Canadian Psychiatric Association; BAP, British Association for Psychopharmacology; TMAP, Texas Medication Algorithm Project; APM, antipsychotic monotherapy; APP, antipsychotic polypharmacy; TRS, treatment-resistant schizophrenia; AP, antipsychotic.