McCutcheon Robert A, Pillinger Toby, Varvari Ioana, Halstead Sean, Ayinde Olatunde O, Crossley Nicolás A, Correll Christoph U, Hahn Margaret, Howes Oliver D, Kane John M, Kabir Thomas, Konradsson-Geuken Åsa, Lennox Belinda, Hui Christy Lai Ming, Rossell Susan L, Solmi Marco, Sommer Iris E, Taipale Heidi, Uchida Hiroyuki, Venkatasubramanian Ganesan, Warren Nicola, Siskind Dan
Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK.
Lancet Psychiatry. 2025 May;12(5):384-394. doi: 10.1016/S2215-0366(25)00031-8. Epub 2025 Mar 31.
Schizophrenia is a mental illness involving multiple symptom domains and is often associated with substantial physical health comorbidities. Guidelines exist, but these tend to be country-specific and are often missing a concise yet comprehensive algorithmic approach. From May 1, 2023, to Jan 1, 2025, International Guidelines for Algorithmic Treatment (INTEGRATE) authors from all UN regions collaborated to develop a consensus guideline focused on the pharmacological treatment of schizophrenia. Following an umbrella review of the literature, input from expert workshops, a consensus survey, and lived experience focus groups, a consensus algorithmic guideline and associated digital tool were developed. Key recommendations include a focus on metabolic health from treatment initiation, timely assessment and management of non-response, symptom domain-specific interventions, mitigation of side-effects, and the prompt use of clozapine in cases of treatment resistance.
精神分裂症是一种涉及多个症状领域的精神疾病，常伴有大量身体健康合并症。虽然存在相关指南，但这些指南往往是针对特定国家的，且常常缺乏简洁而全面的算法方法。从2023年5月1日至2025年1月1日，来自联合国所有区域的国际算法治疗指南（INTEGRATE）作者合作制定了一项侧重于精神分裂症药物治疗的共识指南。在对文献进行伞形综述、专家研讨会的意见、共识调查以及患者体验焦点小组的基础上，制定了一项共识算法指南及相关数字工具。主要建议包括从治疗开始就关注代谢健康、及时评估和管理无反应情况、针对症状领域的特定干预措施、减轻副作用，以及在治疗抵抗的情况下迅速使用氯氮平。
