Review Paper


Managing Schizophrenia During the Stable Phase: Is There Consensus Among Practice Guidelines?

Nadeem H Bhanji, BSc (Pharm), MD1, Raymond Tempier, MD, MSc, FRCPC2

Method: We performed a literature search using Medline and Psycinfo databases and Google Internet search engine.

Results: We identified 6 clinical practice guidelines (CPGs). All stress the need for antipsychotic therapy and psychosocial interventions. Differences lie in types of antipsychotics recommended, duration of antipsychotic trial, management of extrapyramidal symptoms, and types of psychosocial interventions. Areas poorly addressed by all guidelines include definition of the stable phase of schizophrenia, management of adverse effects with atypical agents, management of clozapine nonresponders, and management of personality issues.

Conclusion: Published CPGs are helpful in the management of the stable phase of schizophrenia, although no single CPG series appears to address all treatment needs faced by practising clinicians.

(Can J Psychiatry 2002;47:76–80)

Résumé : Le traitement de la schizophrénie en phase stable : y a-t-il un consensus dans les lignes directrices de la pratique?

Clinical Implications

  • Clinical practice guidelines (CPGs) for managing schizophrenia are useful tools for comparing individual practices with recommendations made by experts.

Limitations

  • The stable phase of schizophrenia needs better definition.
  • Emerging issues with atypical agents need better addressing in future CPGs.
  • Comparison was only possible for those CPGs that were available in the databases searched.