The 2009 schizophrenia patient outcomes research team (PORT) psychopharmacological treatment recommendations

Kreyenbuhl, Julie; Boyer, Robert; Kelly, Deanna L.; Noel, Jason; Boggs, Douglas L.; Fischer, Bernard A.; Himelhoch, Seth; Fang, Beverly; Peterson, Eunice; Aquino, Patrick; Keller, William R.

doi:10.1097/01.yic.0000405726.61759.a4

Cited by 2 publications

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“…The PORT concludes, however, that there is still limited information on the use of adjunctive pharmacological agents as well as the treatment of co-occurring substance abuse [82]. None of the pharmacological agents to date effectively ameliorate cognitive deficits, which are a core feature of schizophrenia; larger and more rigorous studies are needed to examine the potential pro-cognitive effects of medications that impact dopaminergic, nicotinergic, glutamatergic, GABAergic, and other novel targets [84].…”

Section: Pharmacological Treatments In Schizophreniamentioning

confidence: 99%

“…Additionally, amisulpride, olanzapine, clozapine, paliperidone, and risperidone show significantly lower all-cause discontinuation than several other agents [61, 79-81]. The Schizophrenia Patient Outcome Research Team (PORT) summarized strong empirical support for both FGAs and SGAs in acute and maintenance treatment of schizophrenia and for the use of clozapine for treatment-resistant positive symptoms, hostility, and suicidal behaviors [ 82 ].…”

Section: Pharmacological Treatments In Schizophreniamentioning

confidence: 99%

“…Research over the past decade further investigated agents that stimulate the NMDA glutamate receptor, including partial and full agonists at the glycine site and glutamate 2/3 receptor agonists, and found that they may ameliorate negative symptoms with some success if used in conjunction with antipsychotics [ 83 ]. The PORT concludes, however, that there is still limited information on the use of adjunctive pharmacological agents as well as the treatment of co-occurring substance abuse [ 82 ]. None of the pharmacological agents to date effectively ameliorate cognitive deficits, which are a core feature of schizophrenia; larger and more rigorous studies are needed to examine the potential pro-cognitive effects of medications that impact dopaminergic, nicotinergic, glutamatergic, GABAergic, and other novel targets [ 84 ].…”

Section: Pharmacological Treatments In Schizophreniamentioning

confidence: 99%

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Recent advances in understanding schizophrenia

Haller¹,

Padmanabhan²,

Lizano³

et al. 2014

F1000Prime Rep

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Schizophrenia is a highly disabling disorder whose causes remain to be better understood, and treatments have to be improved. However, several recent advances have been made in diagnosis, etiopathology, and treatment. Whereas reliability of diagnosis has improved with operational criteria, including Diagnostic and Statistical Manual of Mental Disorders, (DSM) Fifth Edition, validity of the disease boundaries remains unclear because of substantive overlaps with other psychotic disorders. Recent emphasis on dimensional approaches and translational bio-behavioral research domain criteria may eventually help move toward a neuroscience-based definition of schizophrenia. The etiology of schizophrenia is now thought to be multifactorial, with multiple small-effect and fewer large-effect susceptibility genes interacting with several environmental factors. These factors may lead to developmentally mediated alterations in neuroplasticity, manifesting in a cascade of neurotransmitter and circuit dysfunctions and impaired connectivity with an onset around early adolescence. Such etiopathological understanding has motivated a renewed search for novel pharmacological as well as psychotherapeutic targets. Addressing the core features of the illness, such as cognitive deficits and negative symptoms, and developing hypothesis-driven early interventions and preventive strategies are high-priority goals for the field. Schizophrenia is a severe, chronic mental disorder and is among the most disabling disorders in all of medicine. It is estimated by the National Institute of Mental Health (NIMH) that 2.4 million people over the age of 18 in the US suffer from schizophrenia. This illness typically begins in adolescence and derails the formative goals of school, family, and work, leading to considerable suffering and disability and reduced life expectancy by about 20 years. Treatment outcomes are variable, and some people are successfully treated and reintegrated (i.e. go back to work). Despite the effort of many experts in the field, however, schizophrenia remains a chronic relapsing and remitting disorder associated with significant impairments in social and vocational functioning and a shortened lifespan. Comprehensive treatment entails a multi-modal approach, including psychopharmacology, psychosocial interventions, and assistance with housing and financial sustenance. Research to date suggests a network of genetic, neural, behavioral, and environmental factors to be responsible for its development and course. This article aims to summarize and explain recent advancements in research on schizophrenia, to suggest how these recent discoveries may lead to a better understanding and possible further development of effective therapies, and to highlight the paradigm shifts that have taken place in our understanding of the diagnosis, etiopathology, and treatment.

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Section: Pharmacological Treatments In Schizophreniamentioning

confidence: 99%

Section: Pharmacological Treatments In Schizophreniamentioning

confidence: 99%