Challenges and options in the treatment of schizophrenia

Abstract

Background:When considering antipsychotic treatments for patients with schizophrenia, efficacy must be balanced against the side effects associated with each available treatment option. This balance of benefit versus risk in the choice of treatment should not exclusively depend on the clinical symptoms exhibited by each patient, but should also consider the individual's health and lifestyle characteristics.Methods:A number of agents are available for the management of schizophrenia. To evaluate the advantages and disadvantages of the available antipsychotics, clinicians can use a number of variables to examine available data, such as numbers of patients in the study, the clinical relevance of the scales used to measure efficacy, and statistical significance. In addition, the clinician's evaluation may include a consideration of monitoring of various physiological parameters, which is a requirement with some antipsychotics.Results:Good practice would dictate the regular monitoring of physical health needs as a matter of course, and may improve patient outcome. Monitoring of parameters such as weight gain, and dental health might enable a more effective relationship between clinician and patient. These physical heath parameters might differentiate patients whose treatment is effective against symptoms and those whose quality of life is being optimised. By drawing on the experience of clinicians, we considered which physical health parameters should be measured routinely, and which measures should be considered on an individual patient basis.Conclusion:It is straightforward to combine individualised patient monitoring with antipsychotic and behavioural therapy and might increase the impact of treatments on patients' quality of life.