Management of schizophrenia explained

Management of schizophrenia
Specialty:Psychiatry

The management of schizophrenia usually involves many aspects including psychological, pharmacological, social, educational, and employment-related interventions directed to recovery, and reducing the impact of schizophrenia on quality of life, social functioning, and longevity.[1]

Hospitalization

Hospitalization may occur with severe episodes of schizophrenia. This can be voluntary or (if mental health legislation allows it) involuntary (called civil or involuntary commitment). Long-term inpatient stays are now less common due to deinstitutionalization, although still occur.[2] Following (or in lieu of) a hospital admission, support services available can include drop-in centers, visits from members of a community mental health team or Assertive Community Treatment team, supported employment[3] and patient-led support groups.Efforts to avoid repeated hospitalization include the obtaining of community treatment orders which, following judicial approval, coerce the affected individual to receive psychiatric treatment including long-acting injections of anti-psychotic medication. This legal mechanism has been shown to increase the affected patient's time out of the hospital.[4]

Medication

The mainstay of treatment for schizophrenia is an antipsychotic medication.[5] Most antipsychotics can take around 7 to 14 days to have their full effect. Medication may improve the positive symptoms of schizophrenia, and social and vocational functioning.[6] However, antipsychotics fail to significantly improve the negative symptoms and cognitive dysfunction.[7] [8] There is evidence of clozapine, amisulpride, olanzapine, and risperidone being the most effective medications. However, a high proportion of studies of risperidone were undertaken by its manufacturer, Janssen-Cilag, and should be interpreted with this in mind. In those on antipsychotics, continued use decreases the risk of relapse.[9] [10] There is little evidence regarding consistent benefits from their use beyond two or three years.[10]

Treatment of schizophrenia changed dramatically in the mid-1950s with the development and introduction of the first antipsychotic chlorpromazine.[11] Others such as haloperidol and trifluoperazine soon followed.

It remains unclear whether the newer antipsychotics reduce the chances of developing neuroleptic malignant syndrome, a rare but serious and potentially fatal neurological disorder most often caused by an adverse reaction to antipsychotics (neuroleptics).[12]

Most people on antipsychotics get side effects. People on typical antipsychotics tend to have a higher rate of extrapyramidal side effects while some atypicals are associated with considerable weight gain, diabetes, and risk of metabolic syndrome; this is most pronounced with olanzapine, while risperidone and quetiapine are also associated with weight gain.[13] Risperidone has a similar rate of extrapyramidal symptoms to haloperidol.[13] The American Psychiatric Association generally recommends that atypicals be used as first line treatment in most patients, but further states that therapy should be individually optimized for each patient.[14]

The response of symptoms to medication is variable; treatment resistant schizophrenia is the failure to respond to two or more antipsychotic medications given in therapeutic doses for six weeks or more.[15] Patients in this category may be prescribed clozapine, a medication that may be more effective at reducing symptoms of schizophrenia, but treatment may come with a higher risk of several potentially lethal side effects including agranulocytosis and myocarditis.[16] Clozapine is the only medication proven to be more effective for people who do not respond to other types of antipsychotics.[17] It also appears to reduce suicide in people with schizophrenia. As clozapine suppresses the development of bone marrow, in turn reducing white blood cells which can lead to infection, blood tests are taken for the first six months on this medication.[18] The risk of experiencing agranulocytosis due to clozapine treatment is higher in elderly people, children, and adolescents. The effectiveness in the studies also needs to be interpreted with caution as the studies may have an increased risk of bias.[19]

Studies have found that antipsychotic treatment following NMS and neutropenia may sometimes be successfully rechallenged (restarted) with clozapine.[20] [21]

Tobacco smoking increases the metabolism of some antipsychotics, by strongly activitating CYP1A2, the enzyme that breaks them down, and a significant difference is found in these levels between smokers and non-smokers.[22] It is recommended that the dosage for those smokers on clozapine be increased by 50%, and for those on olanzapine by 30%.[23] The result of stopping smoking can lead to an increased concentration of the antipsychotic that may result in toxicity, so that monitoring of effects would need to take place with a view to decreasing the dosage; many symptoms may be noticeably worsened, and extreme fatigue, and seizures are also possible with a risk of relapse. Likewise those who resume smoking may need their dosages adjusted accordingly.[22] [24] The altering effects are due to compounds in tobacco smoke and not to nicotine; the use of nicotine replacement therapy therefore has the equivalent effect of stopping smoking and monitoring would still be needed.[22]

Research findings suggested that other neurotransmission systems, including serotonin, glutamate, GABA, and acetylcholine, were implicated in the development of schizophrenia, and that a more inclusive medication was needed. A new first-in-class antipsychotic that targets multiple neurotransmitter systems called lumateperone (ITI-007), was trialed and approved by the FDA in December 2019 for the treatment of schizophrenia in adults.[25] [26] [27] Lumateperone is a small molecule agent that shows improved safety, and tolerance. It interacts with dopamine, serotonin, and glutamate in a complex, uniquely selective manner, and is seen to improve negative and positive symptoms, and social functioning.[28] Lumateperone was also found to reduce potential metabolic dysfunction, have lower rates of movement disorders, and have lower cardiovascular side effects such as a fast heart rate.[25]

Add-on agents

Sometimes the use of a second antipsychotic in combination with another is recommended where there has been a poor response. A review of this use found some evidence for an improvement in symptoms but not for relapse or hospitalisation. The use of combination antipsychotics is increasing in spite of limited supporting evidence, with some countries including Finland, France, and the UK recommending its use and others including Canada, Denmark, and Spain in opposition.[29] Anti-inflammatories, anti-depressants, and mood stabilisers are other add-ons used. Other strategies used include ECT, or repetitive transcranial magnetic stimulation (rTMS) but evidence for these is lacking.

Note: Only adjuncts for which at least one double-blind randomized placebo-controlled trial has provided support are listed in this table.

Adjuncts[30] [31] Symptoms against which efficacy is known Notable adverse effects seen in clinical trials Highest quality of clinical data available N Notes
Adjuncts to clozapine[32] [33]
Antipsychotics
Global Extrapyramidal side effects (e.g. tremor, dystonia, akathisia, etc.), headache, somnolence, insomnia, elevated serum prolactin, etc. 1 DB-RPCTs 16 Not approved for use in the US or Canada. Approved for use in Australia, Europe and several countries in East Asia. Can prolong the QT interval, some in vivo evidence[34] suggests it may have anti-diabetogenic effects and hence may improve metabolic parameters in patients on clozapine.
Global, esp. negative Akathisia 1 DB-RPCT 61 Can also improve metabolic side effects of clozapine (including body weight). Six studies so far; only one negative.
Global Impaired cognitive functioning, prolactin elevation and hyperglycaemia 2 DB-RPCTs, 1 DB-RCT 357 (DB-RPCTs) & 24 (DB-RCT)11 studies have been conducted, 5 negative. A meta-analysis found no clinically significant difference between risperidone augmentation and placebo augmentation.
Global Increased serum prolactin 1 DB-RPCT 28 Not approved for use in the US, Canada and Australia.
Global QTc interval prolongation 1 DB-RCT 24 Was compared with risperidone in the one DB-RCT.
Antidepressants
Negative symptoms Well tolerated 1 DB-RPCT 61 Can prolong the QT interval and since clozapine can prolong the QT interval too it is advisable to avoid their concurrent use in patients with cardiovascular risk factors.
Negative and depressive symptoms Elevated serum levels of clozapine (via inhibition of P450 cytochromes) Open-label studies NA Improved metabolic parameters
Negative, depressive and cognitive symptoms Weight gain 2 DB-RPCTs (1 negative) 80 5-HT2A/2C/3 & α2 adrenoceptor antagonist
Anticonvulsants
Negative & depressive symptoms Stevens–Johnson syndrome, toxic epidermal necrolysis, etc. 4 DB-RPCTs (2 negative) 108 Usually a relatively well tolerated anticonvulsant, but because of risk of potentially-fatal dermatologic AEs the dose must be slowly titrated up in order to prevent these AEs. A meta-analysis found that it was ineffective.
Negative symptoms Cognitive impairment, sedation, asthenia 2 DB-RPCTs (1 negative) 57 Can cause cognitive impairment and hence should probably be avoided in patients with cognitive impairments.
Reduced anxiety & depression Weight gain, hair loss One open-label study comparing it with lithium NA Increases the expression of mGluR2 and GAD67 via histone deacetylase (HDAC) inhibition.
Glutamatergic agents[35] [36]
Global Well tolerated 1 DB-RPCT 18 Statistically significant improvement in total symptoms but no significant improvement in negative and positive symptoms when considered separately.
Global Well tolerated 1 DB-RPCT 21 Statistically significant improvement in negative and total symptomtology.
Other
Global Weight gain, hypersalivation 1 DB-RPCT, 1 DB-RCT 10 (DB-RPCT), 20 (DB-RCT) Increased risk of neurological side effects such as neuroleptic malignant syndrome.
Global (especially negative and cognitive symptoms) Well tolerated 3 DB-RPCT (1 negative) 131 Ester of the omega-3 fatty acid, eicosapentaenoic acid.
Adjuncts to other antipsychotics
Anti-inflammatory agents[37] [38]
Aspirin[39] [40] Global (especially positive symptoms) Well tolerated 1 DB-RPCT 70 Increased risk of bleeding, but seems relatively well tolerated.
Global (especially negative symptoms) Well tolerated 3 DB-RPCTs (1 negative) 147 May increased the risk of cardiovascular events (which is particularly worrisome as schizophrenia patients are a higher risk group for cardiovascular events). Case series (N=2) suggests efficacy in augmenting clozapine.
Minocycline[41] [42] [43] [44] Global Well tolerated 4 DB-RPCTs 164 Increased risk of blood dyscarsias.
Global Well tolerated 6 DB-RPCTs (1 negative)[45] 362 May have protective effects against depression.
Pregnenolone[46] [47] [48] [49] Global Well tolerated 3 DB-RPCTs 100 Levels of this neurosteroid in the body are elevated by clozapine treatment.
Glutamatergics[50]
D-alanine[51] [52] Global Well tolerated 1 DB-RPCT 31 A D-amino acid with affinity towards the glycine site on the NMDA receptor.
Global (especially negative symptoms) Well tolerated 4 DB-RPCTs 183 Affinity towards the glycine site on NMDA receptors. D. Souza 2013,[53] Heresco-Levy 2005,[54] Lane 2005,[55] Lane 2010,[56] Tsai 1999,[57] Weiser 2012[58]
Global (predominantly positive symptoms) Well tolerated 5 DB-RPCTs 219 Endogenous NMDA receptor ligand.
N-acetylcysteine[59] Global (especially negative symptoms) Well tolerated 3 DB-RPCTs 140 Cystine and glutathione prodrug.[60] [61] Cystine increases intracellular glutamate levels via the glutamate-cystine anti porter.Berk 2008,[62] Berk 2011,[63] Carmeli 2012,[64] Lavoie 2008[65]
Global (especially negative symptoms) Well tolerated 3 DB-RPCTs 112 GlyT1 antagonist (i.e. glycine reuptake inhibitor). Also known as N-methylglycine. Lane 2005, Lane 2006,[66] Lane 2008,[67] Lane 2010, Tsai 2004[68]
Cholinergics[69] [70]
Global Well tolerated 6 DB-RPCTs (5 negative; or 12 DB-RPCTs if one includes cross-over trials; 8 negative in total) 378, 474 (including cross-over trials) Possesses antidepressant effects according to one trial.
Cognition Well tolerated 5 DB-RPCTs (1 negative) 170 Robust nootropic
Cognition Well tolerated 3 DB-RPCTs (all 3 negative; 5 trials including cross-over trials; 4 negative) 93, 131 (including cross-over trials) Seems to be a weaker nootropic
Tropisetron†[71] [72] [73] [74] Cognitive and negative symptoms Well tolerated 3 DB-RPCTs 120 Agonist at α7 nAChRs; antagonist at 5-HT3. Expensive (>$20 AUD/tablet).
Antidepressants[75]
Escitalopram†[76] Negative symptoms Well tolerated 1 DB-RPCT 40 May increase risk of QT interval prolongation.
Negative symptoms Well tolerated 4 DB-RPCTs (3 negative) 136 The safest of antidepressants listed here in overdose.[77] Risk of QT interval prolongation is lower than with escitalopram (but still exists).
Mianserin[78] Negative and cognitive symptoms Well tolerated 2 DB-RPCTs 48 Weight gain, sedation, dry mouth, constipation and dizziness. Blood dyscarsias are a possible adverse effect and both the Australian Medicines Handbook and British National Formulary 65 (BNF 65) recommend regular complete blood counts to be taken.[79] [80]
Cognition,[81] [82] negative and positive symptoms†[83] Well tolerated ≥4 DB-RPCTs (one negative) 127 Relatively safe in overdose. Produces significant sedation and weight gain, however, which could potentially add to the adverse effects of atypical antipsychotics. Can reduce antipsychotic-induced akathisia.[84]
Negative symptoms Well tolerated 2 DB-RPCTs 73 5-HT2A/2C antagonist. Not clinically available.
Negative symptoms Well tolerated 2 DB-RPCTs 72 5-HT2A antagonist and SSRI. Has sedative effects and hence might exacerbate some of the side effects of atypical antipsychotics.
Other
Alpha-lipoic acid[85] [86] Weight gain Well tolerated 1 DB-RPCT 360 Offset antipsychotic drug-induced weight gain. Increased total antioxidant status. May also increase GSH:GSSG (reduced glutathione:oxidized glutathione) ratio.[87]
L-Theanine[88] [89] [90] Positive, activation, and anxiety symptoms Well tolerated 2 DB-RPCTs 40 Glutamic acid analog. Primary study noted reduction in positive, activation, and anxiety symptoms. Additional studies have noted improvements in attention.[91] [92] [93] [94] Research suggests that theanime has a regulatory effect on the nicotine acetylcholine receptor-dopamine reward pathway, and was shown to reduced dopamine production in the midbrain of mice.[95]
Famotidine†[96] Global Well tolerated 1 DB-RPCT 30 May reduce the absorption of vitamin B12 from the stomach. Might also increase susceptibility to food poisoning.
Tardive dyskinesia, positive symptoms Well tolerated 4 DB-RPCTs 157 Atmaca 2005,[97] Doruk 2008,[98] Zhang 2001,[99] Zhang 2001,[100] Zhang 2006,[101] Zhang 2011,[102] Zhou 1999[103]
Ondansetron[104] Negative and cognitive symptoms Well tolerated 3 DB-RPCTs 151 5-HT3 antagonist. May prolong the QT interval. Expensive (>$4 AUD/tablet).
SAM-e[105] Aggression Well tolerated 1 DB-RPCT 18 Study noted improvement of aggressive behavior and quality of life impairment. while in another study SAM-e has been purported to have a contributory effect on psychosis [106]
Vitamin C[107] [108] [109] [110] Global Well tolerated 1 DB-RPCT 40 Improves BPRS scores.
Acronyms used:
DB-RPCT — Double-blind randomized placebo-controlled trial.
DB-RCT — Double-blind randomized controlled trial.

Note: Global in the context of schizophrenia symptoms here refers to all four symptom clusters.

N refers to the total sample sizes (including placebo groups) of DB-RCTs.

† No secondary sources could be found on the utility of the drug in question, treating the symptom in question (or any symptom in the case of where † has been placed next to the drug's name).

Psychosocial

Psychotherapy is also widely recommended, though not widely used in the treatment of schizophrenia, due to reimbursement problems or lack of training. As a result, treatment is often confined to psychiatric medication.[111]

Cognitive behavioral therapy (CBT) is used to target specific symptoms and improve related issues such as self-esteem and social functioning. Although the results of early trials were inconclusive[112] as the therapy advanced from its initial applications in the mid-1990s, meta-analytic reviews suggested CBT to be an effective treatment for the psychotic symptoms of schizophrenia.[113] [114] Nonetheless, more recent meta analyses have cast doubt upon the utility of CBT as a treatment for the symptoms of psychosis.[115] [116] [117]

Another approach is cognitive remediation therapy, a technique aimed at remediating the neurocognitive deficits sometimes present in schizophrenia. Based on techniques of neuropsychological rehabilitation, early evidence has shown it to be cognitively effective, resulting in the improvement of previous deficits in psychomotor speed, verbal memory, nonverbal memory, and executive function, such improvements being related to measurable changes in brain activation as measured by fMRI.[118]

Metacognitive training (MCT): In view of many empirical findings [119] suggesting deficits of metacognition (thinking about one's thinking, reflecting upon one's cognitive process) in patients with schizophrenia, metacognitive training (MCT) [120] is increasingly adopted as a complementary treatment approach. MCT aims at sharpening the awareness of patients for a variety of cognitive biases (e.g. jumping to conclusions, attributional biases, over-confidence in errors), which are implicated in the formation and maintenance of schizophrenia positive symptoms (especially delusions),[121] and to ultimately replace these biases with functional cognitive strategies. The training consists of 8 modules and can be obtained cost-free from the internet in 15 languages. Studies confirm the training's feasibility [122] and efficacy in ameliorating positive psychosis symptoms.[123] [124] Studies of single training module show that this intervention target specific cognitive biases.[125] Recently, an individualized format has been developed which combines the metacognitive approach with methods derived from cognitive-behavioral therapy.[126]

Family Therapy or Education, which addresses the whole family system of an individual with a diagnosis of schizophrenia, may be beneficial, at least if the duration of intervention is longer-term.[127] [128] [129] A 2010 Cochrane review concluded that many of the clinical trials that studied the effectiveness of family interventions were poorly designed, and may over estimate the effectiveness of the therapy. High-quality randomized controlled trials in this area are required. Aside from therapy, the impact of schizophrenia on families and the burden on careers has been recognized, with the increasing availability of self-help books on the subject.[130] [131] There is also some evidence for benefits from social skills training, although there have also been significant negative findings.[132] Some studies have explored the possible benefits of music therapy and other creative therapies.[133] [134] [135]

The Soteria model is alternative to inpatient hospitalization using full non professional care and a minimal medication approach.[136] Although evidence is limited, a review found the program equally as effective as treatment with medications but due to the limited evidence did not recommend it as a standard treatment.[137] Training in the detection of subtle facial expressions has been used to improve facial emotional recognition.[138]

Avatar Therapy, developed by Professor Julian Leff, was developed to help patients deal with the impact of auditory hallucinations. A 2020 Cochrane review however failed to find any consistent effects in the reviewed studies.[139]

Supplements

Disruption of the gut microbiota has been linked to inflammation, and disorders of the central nervous system. This includes schizophrenia, and probiotic supplementation has been proposed to improve its symptoms. A review found no evidence to support this but it concludes that probiotics may be of benefit in regulating bowel movements and lessening the metabolic effects of antipsychotics.[140]

A review explains the need for an optimal level of vitamin D and omega-3 fatty acids for the proper synthesis and control of the neurotransmitter serotonin. Serotonin regulates executive function, sensory gating, and social behavior – all of which are commonly impaired in schizophrenia. The model proposed suggests that supplementation would help in preventing and treating these brain dysfunctions.[141] Another review finds that omega-3 fatty acids and vitamin D are among the nutritional factors known to have a beneficial effect on mental health.[142] A Cochrane review found evidence to suggest that the use of omega-3 fatty acids in the prodromal stage may prevent the transition to psychosis but the evidence was poor quality and further studies were called for.[143]

Treatment resistant schizophrenia

About half of those with schizophrenia will respond favourably to antipsychotics, and have a good return of functioning.[144] However, positive symptoms persist in up to a third of people. Following two trials of different antipsychotics over six weeks, that also prove ineffective, they will be classed as having treatment resistant schizophrenia (TRS), and clozapine will be offered.[145] Clozapine is of benefit to around half of this group although it has the potentially serious side effect of agranulocytosis (lowered white blood cell count) in less than 4% of people.[146] [147] [148] Between 12 and 20 per cent will not respond to clozapine and this group is said to have ultra treatment resistant schizophrenia.[149] [150] ECT may be offered to treat TRS as an add-on therapy, and is shown to sometimes be of benefit.[150] A review concluded that this use only has an effect on medium-term TRS and that there is not enough evidence to support its use other than for this group.[151]

TRS is often accompanied by a low quality of life, and greater social dysfunction.[152] TRS may be the result of inadequate rather than inefficient treatment; it also may be a false label due to medication not being taken regularly, or at all.[153] About 16 per cent of people who had initially been responsive to treatment later develop resistance. This could relate to the length of time on APs, with treatment becoming less responsive.[154] This finding also supports the involvement of dopamine in the development of schizophrenia.[153] Studies suggest that TRS may be a more heritable form.

TRS may be evident from first episode psychosis, or from a relapse. It can vary in its intensity and response to other therapies.[152] This variation is seen to possibly indicate an underlying neurobiology such as dopamine supersensitivity (DSS), glutamate or serotonin dysfunction, inflammation and oxidative stress.[149] Studies have found that dopamine supersensitivity is found in up to 70% of those with TRS.[155] The variation has led to the suggestion that treatment responsive and treatment resistant schizophrenia be considered as two different subtypes.[149] [156] It is further suggested that if the subtypes could be distinguished at an early stage significant implications could follow for treatment considerations, and for research.[150] Neuroimaging studies have found a significant decrease in the volume of grey matter in those with TRS with no such change seen in those who are treatment responsive.[150] In those with ultra treatment resistance the decrease in grey matter volume was larger.[149] [150]

Rehabilitative interventions

Individual Placement and Support (IPS), where the rehabilitated person is directly placed and supported in the workplace with the support of a professional, promotes the employment of people with schizophrenia and their survival in the open labour market better than the model of gradual work practice before placement.[157]

Research evidence on the relative superiority of different types of housing units for people with psychosis in terms of symptomatic or functional development is scarce. The support and independence provided in a residential unit should be flexible, individualised and, as far as possible, at the choice of the person being rehabilitated. The living environment should be as normal as possible and the rehabilitated person should not be isolated from the rest of the community.[158] [159]

Traditional Chinese medicine

Acupuncture is a procedure generally known to be safe and with few adverse effects. A Cochrane review found limited evidence for its possible antipsychotic effects in the treatment of schizophrenia and called for more studies.[160] Another review found limited evidence for its use as an add-on therapy for the relief of symptoms but positive results were found for the treatment of sleep disorders that often accompany schizophrenia.[161]

Wendan decoction is a classic herbal treatment in traditional Chinese medicine used for symptoms of psychosis, and other conditions. Wendan decoction is safe, accessible, and inexpensive, and a Cochrane review was carried out for its possible effects on schizophrenia symptoms. Limited evidence was found for its positive antipsychotic effects in the short term, and it was associated with fewer adverse effects. Used as an add-on to an antipsychotic, wider positive effects were found. Larger studies of improved quality were called for.[162] [163]

Other

Various brain stimulation techniques have been used to treat the positive symptoms of schizophrenia, in particular auditory verbal hallucinations (AVHs), and investigations are ongoing.[164] Most studies focus on transcranial direct-current stimulation (tDCM), and repetitive transcranial magnetic stimulation (rTMS).[165] Transcranial magnetic stimulation is low-cost, noninvasive, and almost free of side-effects making it a good therapeutic choice with promising outcomes.[164] Low-frequency TMS of the left temporoparietal cortex (the region containing Broca's area) can reduce auditory hallucinations.[164] rTMS seems to be the most effective treatment for those with persistent AVHs, as an add-on therapy.[165] AVHs are not resolved in up to 30 per cent of those on antipsychotics and a further percentage still experience only a partial response.[165] Techniques based on focused ultrasound for deep brain stimulation could provide insight for the treatment of AVHs.[165]

An established brain stimulation treatment is electroconvulsive therapy. This is not considered a first-line treatment but may be prescribed in cases where other treatments have failed. It is more effective where symptoms of catatonia are present,[166] and is recommended for use under NICE guidelines in the UK for catatonia if previously effective, though there is no recommendation for use for schizophrenia otherwise.[167] Psychosurgery has now become a rare procedure and is not a recommended treatment for schizophrenia.[168]

A study in 2014 conducted by an Australian researcher indicated that the pericarp powder of Garcinia mangostana L. have the ability to reduce oxidative stress as an effective treatment for schizophrenia. This process includes increasing glutathione S-transferase levels which enhances mitochondrial activity over a period of 180 days under a sustained intake of 1000 mg/day.[169]

There may be some benefit in trying several treatment modalities at the same time, especially those that could be classed as lifestyle interventions.[170] Nidotherapy is suggested to be a cost-effective social prescribing intervention using efforts to change the environment to improve functional ability.[171]

Numerous people diagnosed with schizophrenia have found it necessary to organize confidential groups with each other where they can discuss their experiences without clinicians present.[172] [173] Peer support in which people with experiential knowledge of mental illness provide knowledge, experience, emotional, social or practical help to each other is considered an important aspect of coping with schizophrenia and other serious mental health conditions. A 2019 Cochrane reviews of evidence for peer-support interventions compared to supportive or psychosocial interventions were unable to support or refute the effectiveness of peer-support due to limited data.[174]

Notes and References

  1. Web site: Psychosis and schizophrenia in adults: treatment and management | Key-priorities-for-implementation | Guidance and guidelines . The United Kingdom National Institute for Health and Care Excellence (NICE) . 12 February 2014 .
  2. Becker T, Kilian R . Psychiatric services for people with severe mental illness across western Europe: what can be generalized from current knowledge about differences in provision, costs and outcomes of mental health care? . Acta Psychiatrica Scandinavica. Supplementum . 113 . 429 . 9–16 . 2006 . 16445476 . 10.1111/j.1600-0447.2005.00711.x . 34615961 .
  3. McGurk SR, Mueser KT, Feldman K, Wolfe R, Pascaris A . Cognitive training for supported employment: 2–3 year outcomes of a randomized controlled trial . The American Journal of Psychiatry . 164 . 3 . 437–41 . March 2007 . 17329468 . 10.1176/appi.ajp.164.3.437 .
  4. Frank D, Perry JC, Kean D, Sigman M, Geagea K . Effects of compulsory treatment orders on time to hospital readmission . Psychiatric Services . Washington, D.C. . 56 . 7 . 867–9 . July 2005 . 16020822 . 10.1176/appi.ps.56.7.867 .
  5. Book: National Collaborating Centre for Mental Health . National Institute for Clinical Excellence . Schizophrenia : full national clinical guideline on core interventions in primary and secondary care . 2003 . Gaskell, Royal College of Psychiatrists . London . 978-1-901242-97-3 . https://web.archive.org/web/20070927014932/http://www.nice.org.uk/download.aspx?o=289559 . 2007-09-27.
  6. Eiring Ø, Landmark BF, Aas E, Salkeld G, Nylenna M, Nytrøen K . What matters to patients? A systematic review of preferences for medication-associated outcomes in mental disorders . BMJ Open . 5 . 4 . e007848 . April 2015 . 25854979 . 4390680 . 10.1136/bmjopen-2015-007848 .
  7. Smith T, Weston C, Lieberman J . Schizophrenia (maintenance treatment) . American Family Physician . 82 . 4 . 338–9 . August 2010 . 20704164 .
  8. Tandon R, Keshavan MS, Nasrallah HA . Schizophrenia, "Just the Facts": what we know in 2008 part 1: overview . Schizophrenia Research . 100 . 1–3 . 4–19 . March 2008 . 18291627 . 10.1016/j.schres.2008.01.022 . 14598183 .
  9. Leucht S, Tardy M, Komossa K, Heres S, Kissling W, Salanti G, Davis JM . Antipsychotic drugs versus placebo for relapse prevention in schizophrenia: a systematic review and meta-analysis . Lancet . 379 . 9831 . 2063–71 . June 2012 . 22560607 . 10.1016/S0140-6736(12)60239-6 . 2018124 .
  10. Harrow M, Jobe TH . Does long-term treatment of schizophrenia with antipsychotic medications facilitate recovery? . Schizophrenia Bulletin . 39 . 5 . 962–5 . September 2013 . 23512950 . 3756791 . 10.1093/schbul/sbt034 .
  11. Turner T . Chlorpromazine: unlocking psychosis . BMJ . 334 . s7 . January 2007 . Suppl 1 . 17204765 . 10.1136/bmj.39034.609074.94 . 33739419 .
  12. Ananth J, Parameswaran S, Gunatilake S, Burgoyne K, Sidhom T . Neuroleptic malignant syndrome and atypical antipsychotic drugs . The Journal of Clinical Psychiatry . 65 . 4 . 464–70 . April 2004 . 15119907 . 10.4088/JCP.v65n0403 . 32752143 .
  13. Barry SJ, Gaughan TM, Hunter R . Schizophrenia . BMJ Clinical Evidence . 2012 . June 2012 . 23870705 . 3385413 . dead . https://archive.today/20140911114812/http://www.clinicalevidence.bmj.com/x/systematic-review/1007/archive/06/2012.html . 2014-09-11 .
  14. Lehman AF, Lieberman JA, Dixon LB, McGlashan TH, Miller AL, Perkins DO, Kreyenbuhl J, McIntyre JS, Charles SC, Altshuler K, Cook I . 6 . Practice Guideline for the Treatment of Patients With Schizophrenia . 2nd . American Journal of Psychiatry . February 2004 . 161 . 2 supplement . American Psychological Association (APA) . https://archive.today/20140306093804/http://psychiatryonline.org/content.aspx?bookID=28&sectionID=1665359%2346267#46267 . dead . 2014-03-06 .
  15. Book: Semple D, Smyth R . Oxford Handbook of Psychiatry . Oxford University Press . July 2019 . 207 . 978-0-19-251496-7 .
  16. Haas SJ, Hill R, Krum H, Liew D, Tonkin A, Demos L, Stephan K, McNeil J . 6 . Clozapine-associated myocarditis: a review of 116 cases of suspected myocarditis associated with the use of clozapine in Australia during 1993–2003 . Drug Safety . 30 . 1 . 47–57 . 2007 . 17194170 . 10.2165/00002018-200730010-00005 . 1153693 .
  17. Lieberman JA, Stroup TS, McEvoy JP, Swartz MS, Rosenheck RA, Perkins DO, Keefe RS, Davis SM, Davis CE, Lebowitz BD, Severe J, Hsiao JK . 6 . Effectiveness of antipsychotic drugs in patients with chronic schizophrenia . The New England Journal of Medicine . 353 . 12 . 1209–23 . September 2005 . 16172203 . 10.1056/NEJMoa051688 . 22499842 . Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Investigators . free .
  18. Book: Kozier B, Erb G, Olivieri R, Snyder S, Lake R, Harvey S. Chapter 10: Mental health . https://books.google.com/books?id=_0_pRyy9McQC&q=clozapine&pg=PA189 . Fundamentals of Nursing: Concepts, Process and Practice . 2008 . Pearson Education . Harlow, England . 978-0-13-197653-5 . 1st adaptation . 189 .
  19. Essali A, Al-Haj Haasan N, Li C, Rathbone J . Clozapine versus typical neuroleptic medication for schizophrenia . The Cochrane Database of Systematic Reviews . 1 . CD000059 . January 2009 . 2009 . 19160174 . 7065592 . 10.1002/14651858.cd000059.pub2 .
  20. Manu P, Lapitskaya Y, Shaikh A, Nielsen J . 3689529 . Clozapine Rechallenge After Major Adverse Effects: Clinical Guidelines Based on 259 Cases. . American Journal of Therapeutics . 25 . 2 . e218–e223 . 2018 . 29505490 . 10.1097/MJT.0000000000000715. free .
  21. Lally J, McCaffrey C, O Murchu C . etal . 189945135 . Clozapine Rechallenge Following Neuroleptic Malignant Syndrome: A Systematic Review . Journal of Clinical Psychopharmacology . 39 . 4 . 372–379 . July 2019 . 31205196. 10.1097/JCP.0000000000001048.
  22. Cather C, Pachas GN, Cieslak KM, Evins AE . Achieving Smoking Cessation in Individuals with Schizophrenia: Special Considerations . CNS Drugs . 31 . 6 . 471–481 . June 2017 . 28550660. 10.1007/s40263-017-0438-8. 5646360 .
  23. Tsuda Y, Saruwatari J, Yasui-Furukori N . Meta-analysis: the effects of smoking on the disposition of two commonly used antipsychotic agents, olanzapine and clozapine . BMJ Open . 4 . 3 . e004216 . 4 March 2014 . 24595134. 10.1136/bmjopen-2013-004216. 3948577 .
  24. Lowe EJ, Ackman ML . 11456024 . Impact of tobacco smoking cessation on stable clozapine or olanzapine treatment . The Annals of Pharmacotherapy . April 2010 . 44 . 4 . 727–32 . 10.1345/aph.1M398 . 20233914.
  25. Li P, Snyder GL, Vanover KE . Dopamine Targeting Drugs for the Treatment of Schizophrenia: Past, Present and Future . Current Topics in Medicinal Chemistry . 16 . 29 . 3385–3403 . 2016 . 27291902. 10.2174/1568026616666160608084834 . 5112764 .
  26. Web site: FDA Approves Caplyta (lumateperone) for the Treatment of Schizophrenia in Adults . 23 December 2019 . drugs.com .
  27. Blair HA . 211110160 . Lumateperone: First Approval . Drugs . 14 February 2020 . 80 . 4 . 417–423 . 32060882. 10.1007/s40265-020-01271-6.
  28. Edinoff A, Wu N, deBoisblanc C . etal . Lumateperone for the Treatment of Schizophrenia . Psychopharmacol Bull . 50 . 4 . 32–59 . September 2020 . 33012872 . 7511146 .
  29. Ortiz-Orendain J, Castiello-de Obeso S, Colunga-Lozano LE, Hu Y, Maayan N, Adams CE . Antipsychotic combinations for schizophrenia . The Cochrane Database of Systematic Reviews . 6 . CD009005 . June 2017 . 10 . 28658515 . 6481822 . 10.1002/14651858.CD009005.pub2 . Review .
  30. Book: 9789400758056 . Polypharmacy in Psychiatry Practice, Volume I . Ritsner MS . 2013 . Springer Science+Business Media Dordrecht . 10.1007/978-94-007-5805-6 . 7705779 . Ritsner MS .
  31. Book: 9789400757998 . Ritsner MS . Polypharmacy in Psychiatry Practice, Volume II . 2013 . Springer Science+Business Media Dordrecht . 10.1007/978-94-007-5799-8 . 2077519 . Ritsner MS .
  32. Porcelli S, Balzarro B, Serretti A . Clozapine resistance: augmentation strategies . European Neuropsychopharmacology . 22 . 3 . 165–82 . March 2012 . 21906915 . 10.1016/j.euroneuro.2011.08.005 . 39716777 .
  33. Sommer IE, Begemann MJ, Temmerman A, Leucht S . Pharmacological augmentation strategies for schizophrenia patients with insufficient response to clozapine: a quantitative literature review . Schizophrenia Bulletin . 38 . 5 . 1003–11 . September 2012 . 21422107 . 3446238 . 10.1093/schbul/sbr004 .
  34. Roix JJ, DeCrescenzo GA, Cheung PH, Ciallella JR, Sulpice T, Saha S, Halse R . Effect of the antipsychotic agent amisulpride on glucose lowering and insulin secretion . Diabetes, Obesity & Metabolism . 14 . 4 . 329–34 . April 2012 . 22059694 . 10.1111/j.1463-1326.2011.01529.x . 28553141 .
  35. Singh SP, Singh V . Meta-analysis of the efficacy of adjunctive NMDA receptor modulators in chronic schizophrenia . CNS Drugs . 25 . 10 . 859–85 . October 2011 . 21936588 . 10.2165/11586650-000000000-00000 . 207299820 .
  36. Choi KH, Wykes T, Kurtz MM . Adjunctive pharmacotherapy for cognitive deficits in schizophrenia: meta-analytical investigation of efficacy . The British Journal of Psychiatry . 203 . 3 . 172–8 . September 2013 . 23999481 . 3759029 . 10.1192/bjp.bp.111.107359 .
  37. Keller WR, Kum LM, Wehring HJ, Koola MM, Buchanan RW, Kelly DL . A review of anti-inflammatory agents for symptoms of schizophrenia . Journal of Psychopharmacology . 27 . 4 . 337–42 . April 2013 . 23151612 . 3641824 . 10.1177/0269881112467089 .
  38. Sommer IE, van Westrhenen R, Begemann MJ, de Witte LD, Leucht S, Kahn RS . Efficacy of anti-inflammatory agents to improve symptoms in patients with schizophrenia: an update . Schizophrenia Bulletin . 40 . 1 . 181–91 . January 2014 . 24106335 . 3885306 . 10.1093/schbul/sbt139 .
  39. Laan W, Grobbee DE, Selten JP, Heijnen CJ, Kahn RS, Burger H . Adjuvant aspirin therapy reduces symptoms of schizophrenia spectrum disorders: results from a randomized, double-blind, placebo-controlled trial . The Journal of Clinical Psychiatry . 71 . 5 . 520–7 . May 2010 . 20492850 . 10.4088/JCP.09m05117yel . 11370/5644f8cd-b8ea-4ecc-9755-0f7c9ed86d02 .
  40. Schmidt L, Phelps E, Friedel J, Shokraneh F . Acetylsalicylic acid (aspirin) for schizophrenia . The Cochrane Database of Systematic Reviews . 2019 . CD012116 . August 2019 . 8 . 31425623 . 6699651 . 10.1002/14651858.CD012116.pub2 .
  41. Liu F, Guo X, Wu R, Ou J, Zheng Y, Zhang B, Xie L, Zhang L, Yang L, Yang S, Yang J, Ruan Y, Zeng Y, Xu X, Zhao J . 6 . Minocycline supplementation for treatment of negative symptoms in early-phase schizophrenia: a double blind, randomized, controlled trial . Schizophrenia Research . 153 . 1–3 . 169–76 . March 2014 . 24503176 . 10.1016/j.schres.2014.01.011 . 5908680 .
  42. Khodaie-Ardakani MR, Mirshafiee O, Farokhnia M, Tajdini M, Hosseini SM, Modabbernia A, Rezaei F, Salehi B, Yekehtaz H, Ashrafi M, Tabrizi M, Akhondzadeh S . 6 . Minocycline add-on to risperidone for treatment of negative symptoms in patients with stable schizophrenia: randomized double-blind placebo-controlled study . Psychiatry Research . 215 . 3 . 540–6 . March 2014 . 24480077 . 10.1016/j.psychres.2013.12.051 . 5442977 .
  43. Chaudhry IB, Hallak J, Husain N, Minhas F, Stirling J, Richardson P, Dursun S, Dunn G, Deakin B . 6 . Minocycline benefits negative symptoms in early schizophrenia: a randomised double-blind placebo-controlled clinical trial in patients on standard treatment . Journal of Psychopharmacology . 26 . 9 . 1185–93 . September 2012 . 22526685 . 10.1177/0269881112444941 . 19246435 .
  44. Levkovitz Y, Mendlovich S, Riwkes S, Braw Y, Levkovitch-Verbin H, Gal G, Fennig S, Treves I, Kron S . 6 . A double-blind, randomized study of minocycline for the treatment of negative and cognitive symptoms in early-phase schizophrenia . The Journal of Clinical Psychiatry . 71 . 2 . 138–49 . February 2010 . 19895780 . 10.4088/JCP.08m04666yel . 10554795 .
  45. Joy CB, Mumby-Croft R, Joy LA . Polyunsaturated fatty acid supplementation for schizophrenia . The Cochrane Database of Systematic Reviews . 3 . CD001257 . July 2006 . 2006 . 16855961 . 7032618 . 10.1002/14651858.CD001257.pub2 .
  46. Ritsner MS, Gibel A, Shleifer T, Boguslavsky I, Zayed A, Maayan R, Weizman A, Lerner V . 6 . Pregnenolone and dehydroepiandrosterone as an adjunctive treatment in schizophrenia and schizoaffective disorder: an 8-week, double-blind, randomized, controlled, 2-center, parallel-group trial . The Journal of Clinical Psychiatry . 71 . 10 . 1351–62 . October 2010 . 20584515 . 10.4088/JCP.09m05031yel . 25628072 .
  47. Marx CE, Keefe RS, Buchanan RW, Hamer RM, Kilts JD, Bradford DW, Strauss JL, Naylor JC, Payne VM, Lieberman JA, Savitz AJ, Leimone LA, Dunn L, Porcu P, Morrow AL, Shampine LJ . 6 . Proof-of-concept trial with the neurosteroid pregnenolone targeting cognitive and negative symptoms in schizophrenia . Neuropsychopharmacology . 34 . 8 . 1885–903 . July 2009 . 19339966 . 3427920 . 10.1038/npp.2009.26 .
  48. Wong P, Chang CC, Marx CE, Caron MG, Wetsel WC, Zhang X . Pregnenolone rescues schizophrenia-like behavior in dopamine transporter knockout mice . PLOS ONE . 7 . 12 . e51455 . 2012 . 23240026 . 3519851 . 10.1371/journal.pone.0051455 . Hashimoto K . 2012PLoSO...751455W . free .
  49. Marx CE, Stevens RD, Shampine LJ, Uzunova V, Trost WT, Butterfield MI, Massing MW, Hamer RM, Morrow AL, Lieberman JA . 6 . Neuroactive steroids are altered in schizophrenia and bipolar disorder: relevance to pathophysiology and therapeutics . Neuropsychopharmacology . 31 . 6 . 1249–63 . June 2006 . 16319920 . 10.1038/sj.npp.1300952 . 2499760 . free .
  50. Javitt DC, Zukin SR, Heresco-Levy U, Umbricht D . Has an angel shown the way? Etiological and therapeutic implications of the PCP/NMDA model of schizophrenia . Schizophrenia Bulletin . 38 . 5 . 958–66 . September 2012 . 22987851 . 3446214 . 10.1093/schbul/sbs069 .
  51. Hatano T, Ohnuma T, Sakai Y, Shibata N, Maeshima H, Hanzawa R, Suzuki T, Arai H . 6 . Plasma alanine levels increase in patients with schizophrenia as their clinical symptoms improve-Results from the Juntendo University Schizophrenia Projects (JUSP) . Psychiatry Research . 177 . 1–2 . 27–31 . May 2010 . 20226539 . 10.1016/j.psychres.2010.02.014 . 10174006 .
  52. Tsai GE, Yang P, Chang YC, Chong MY . D-alanine added to antipsychotics for the treatment of schizophrenia . Biological Psychiatry . 59 . 3 . 230–4 . February 2006 . 16154544 . 10.1016/j.biopsych.2005.06.032 . 19372446 .
  53. D'Souza DC, Radhakrishnan R, Perry E, Bhakta S, Singh NM, Yadav R, Abi-Saab D, Pittman B, Chaturvedi SK, Sharma MP, Bell M, Andrade C . 6 . Feasibility, safety, and efficacy of the combination of D-serine and computerized cognitive retraining in schizophrenia: an international collaborative pilot study . Neuropsychopharmacology . 38 . 3 . 492–503 . February 2013 . 23093223 . 3547200 . 10.1038/npp.2012.208 .
  54. Heresco-Levy U, Javitt DC, Ebstein R, Vass A, Lichtenberg P, Bar G, Catinari S, Ermilov M . 6 . D-serine efficacy as add-on pharmacotherapy to risperidone and olanzapine for treatment-refractory schizophrenia . Biological Psychiatry . 57 . 6 . 577–85 . March 2005 . 15780844 . 10.1016/j.biopsych.2004.12.037 . 46348188 .
  55. Lane HY, Chang YC, Liu YC, Chiu CC, Tsai GE . Sarcosine or D-serine add-on treatment for acute exacerbation of schizophrenia: a randomized, double-blind, placebo-controlled study . Archives of General Psychiatry . 62 . 11 . 1196–204 . November 2005 . 16275807 . 10.1001/archpsyc.62.11.1196 .
  56. Lane HY, Lin CH, Huang YJ, Liao CH, Chang YC, Tsai GE . A randomized, double-blind, placebo-controlled comparison study of sarcosine (N-methylglycine) and D-serine add-on treatment for schizophrenia . The International Journal of Neuropsychopharmacology . 13 . 4 . 451–60 . May 2010 . 19887019 . 10.1017/S1461145709990939 . free .
  57. Tsai GE, Yang P, Chung LC, Tsai IC, Tsai CW, Coyle JT . D-serine added to clozapine for the treatment of schizophrenia . The American Journal of Psychiatry . 156 . 11 . 1822–5 . November 1999 . 10553752 . 10.1176/ajp.156.11.1822 . 29054148 .
  58. Weiser M, Heresco-Levy U, Davidson M, Javitt DC, Werbeloff N, Gershon AA, Abramovich Y, Amital D, Doron A, Konas S, Levkovitz Y, Liba D, Teitelbaum A, Mashiach M, Zimmerman Y . 6 . A multicenter, add-on randomized controlled trial of low-dose d-serine for negative and cognitive symptoms of schizophrenia . The Journal of Clinical Psychiatry . 73 . 6 . e728-34 . June 2012 . 22795211 . 10.4088/JCP.11m07031 .
  59. Dean O, Giorlando F, Berk M . N-acetylcysteine in psychiatry: current therapeutic evidence and potential mechanisms of action . Journal of Psychiatry & Neuroscience . 36 . 2 . 78–86 . March 2011 . 21118657 . 3044191 . 10.1503/jpn.100057 .
  60. Aoyama K, Watabe M, Nakaki T . Regulation of neuronal glutathione synthesis . Journal of Pharmacological Sciences . 108 . 3 . 227–38 . November 2008 . 19008644 . 10.1254/jphs.08R01CR . free .
  61. Jain A, Mårtensson J, Stole E, Auld PA, Meister A . Glutathione deficiency leads to mitochondrial damage in brain . Proceedings of the National Academy of Sciences of the United States of America . 88 . 5 . 1913–7 . March 1991 . 2000395 . 51136 . 10.1073/pnas.88.5.1913 . 1991PNAS...88.1913J . free .
  62. Berk M, Copolov D, Dean O, Lu K, Jeavons S, Schapkaitz I, Anderson-Hunt M, Judd F, Katz F, Katz P, Ording-Jespersen S, Little J, Conus P, Cuenod M, Do KQ, Bush AI . 6 . N-acetyl cysteine as a glutathione precursor for schizophrenia—a double-blind, randomized, placebo-controlled trial . Biological Psychiatry . 64 . 5 . 361–8 . September 2008 . 18436195 . 10.1016/j.biopsych.2008.03.004 . 10321144 .
  63. Berk M, Munib A, Dean O, Malhi GS, Kohlmann K, Schapkaitz I, Jeavons S, Katz F, Anderson-Hunt M, Conus P, Hanna B, Otmar R, Ng F, Copolov DL, Bush AI . 6 . Qualitative methods in early-phase drug trials: broadening the scope of data and methods from an RCT of N-acetylcysteine in schizophrenia . The Journal of Clinical Psychiatry . 72 . 7 . 909–13 . July 2011 . 20868637 . 10.4088/JCP.09m05741yel .
  64. Carmeli C, Knyazeva MG, Cuénod M, Do KQ . Glutathione precursor N-acetyl-cysteine modulates EEG synchronization in schizophrenia patients: a double-blind, randomized, placebo-controlled trial . PLOS ONE . 7 . 2 . e29341 . 2012 . 22383949 . 3285150 . 10.1371/journal.pone.0029341 . Burne T . 2012PLoSO...729341C . free .
  65. Lavoie S, Murray MM, Deppen P, Knyazeva MG, Berk M, Boulat O, Bovet P, Bush AI, Conus P, Copolov D, Fornari E, Meuli R, Solida A, Vianin P, Cuénod M, Buclin T, Do KQ . 6 . Glutathione precursor, N-acetyl-cysteine, improves mismatch negativity in schizophrenia patients . Neuropsychopharmacology . 33 . 9 . 2187–99 . August 2008 . 18004285 . 10.1038/sj.npp.1301624 . 237232 . free . 10536/DRO/DU:30071388 . free .
  66. Lane HY, Huang CL, Wu PL, Liu YC, Chang YC, Lin PY, Chen PW, Tsai G . 6 . Glycine transporter I inhibitor, N-methylglycine (sarcosine), added to clozapine for the treatment of schizophrenia . Biological Psychiatry . 60 . 6 . 645–9 . September 2006 . 16780811 . 10.1016/j.biopsych.2006.04.005 . 42741531 .
  67. Lane HY, Liu YC, Huang CL, Chang YC, Liau CH, Perng CH, Tsai GE . Sarcosine (N-methylglycine) treatment for acute schizophrenia: a randomized, double-blind study . Biological Psychiatry . 63 . 1 . 9–12 . January 2008 . 17659263 . 10.1016/j.biopsych.2007.04.038 . 26037874 .
  68. Tsai G, Lane HY, Yang P, Chong MY, Lange N . Glycine transporter I inhibitor, N-methylglycine (sarcosine), added to antipsychotics for the treatment of schizophrenia . Biological Psychiatry . 55 . 5 . 452–6 . March 2004 . 15023571 . 10.1016/j.biopsych.2003.09.012 . 35723786 .
  69. Singh J, Kour K, Jayaram MB . Acetylcholinesterase inhibitors for schizophrenia . The Cochrane Database of Systematic Reviews . 1 . CD007967 . January 2012 . 1 . 22258978 . 6823258 . 10.1002/14651858.CD007967.pub2 .
  70. Ribeiz SR, Bassitt DP, Arrais JA, Avila R, Steffens DC, Bottino CM . Cholinesterase inhibitors as adjunctive therapy in patients with schizophrenia and schizoaffective disorder: a review and meta-analysis of the literature . CNS Drugs . 24 . 4 . 303–17 . April 2010 . 20297855 . 10.2165/11530260-000000000-00000 . 45807136 .
  71. Koike K, Hashimoto K, Takai N, Shimizu E, Komatsu N, Watanabe H, Nakazato M, Okamura N, Stevens KE, Freedman R, Iyo M . 6 . Tropisetron improves deficits in auditory P50 suppression in schizophrenia . Schizophrenia Research . 76 . 1 . 67–72 . July 2005 . 15927799 . 10.1016/j.schres.2004.12.016 . 25260365 .
  72. Shiina A, Shirayama Y, Niitsu T, Hashimoto T, Yoshida T, Hasegawa T, Haraguchi T, Kanahara N, Shiraishi T, Fujisaki M, Fukami G, Nakazato M, Iyo M, Hashimoto K . 6 . A randomised, double-blind, placebo-controlled trial of tropisetron in patients with schizophrenia . Annals of General Psychiatry . 9 . 1 . 27 . June 2010 . 20573264 . 2901366 . 10.1186/1744-859X-9-27 . free .
  73. Zhang XY, Liu L, Liu S, Hong X, Chen DC, Xiu MH, Yang FD, Zhang Z, Zhang X, Kosten TA, Kosten TR . 6 . Short-term tropisetron treatment and cognitive and P50 auditory gating deficits in schizophrenia . The American Journal of Psychiatry . 169 . 9 . 974–81 . September 2012 . 22952075 . 10.1176/appi.ajp.2012.11081289 .
  74. Noroozian M, Ghasemi S, Hosseini SM, Modabbernia A, Khodaie-Ardakani MR, Mirshafiee O, Farokhnia M, Tajdini M, Rezaei F, Salehi B, Ashrafi M, Yekehtaz H, Tabrizi M, Akhondzadeh S . 6 . A placebo-controlled study of tropisetron added to risperidone for the treatment of negative symptoms in chronic and stable schizophrenia . Psychopharmacology . 228 . 4 . 595–602 . August 2013 . 23515583 . 10.1007/s00213-013-3064-2 . 15652697 .
  75. Singh SP, Singh V, Kar N, Chan K . Efficacy of antidepressants in treating the negative symptoms of chronic schizophrenia: meta-analysis . The British Journal of Psychiatry . 197 . 3 . 174–9 . September 2010 . 20807960 . 10.1192/bjp.bp.109.067710 . free .
  76. Iancu I, Tschernihovsky E, Bodner E, Piconne AS, Lowengrub K . Escitalopram in the treatment of negative symptoms in patients with chronic schizophrenia: a randomized double-blind placebo-controlled trial . Psychiatry Research . 179 . 1 . 19–23 . August 2010 . 20472299 . 10.1016/j.psychres.2010.04.035 . 261170 .
  77. White N, Litovitz T, Clancy C . Suicidal antidepressant overdoses: a comparative analysis by antidepressant type . Journal of Medical Toxicology . 4 . 4 . 238–50 . December 2008 . 19031375 . 3550116 . 10.1007/BF03161207 .
  78. Hecht EM, Landy DC . Alpha-2 receptor antagonist add-on therapy in the treatment of schizophrenia; a meta-analysis . Schizophrenia Research . 134 . 2–3 . 202–6 . February 2012 . 22169246 . 10.1016/j.schres.2011.11.030 . 36119981 .
  79. Book: Rossi, S . 978-0-9805790-9-3 . Australian Medicines Handbook . Adelaide . The Australian Medicines Handbook Unit Trust . 2013 . 2013 .
  80. Book: 978-0-85711-084-8 . British National Formulary (BNF) . Joint Formulary Committee . 2013 . Pharmaceutical Press . London, UK . 65 . 247 .
  81. Book: 9789400758056. Polypharmacy in Psychiatry Practice, Volume I . Ritsner MS . 2013. Springer Science+Business Media Dordrecht. 10.1007/978-94-007-5805-6. 7705779. Ritsner MS .
  82. Vidal C, Reese C, Fischer BA, Chiapelli J, Himelhoch S . Meta-Analysis of Efficacy of Mirtazapine as an Adjunctive Treatment of Negative Symptoms in Schizophrenia . Clinical Schizophrenia & Related Psychoses . 9 . 2 . 88–95 . March 2013 . 23491969 . 10.3371/CSRP.VIRE.030813 .
  83. Stenberg JH, Terevnikov V, Joffe M, Tiihonen J, Tchoukhine E, Burkin M, Joffe G . More evidence on proneurocognitive effects of add-on mirtazapine in schizophrenia . Progress in Neuro-Psychopharmacology & Biological Psychiatry . 35 . 4 . 1080–6 . June 2011 . 21402120 . 10.1016/j.pnpbp.2011.03.004 . 37328991 .
  84. Kumar R, Sachdev PS . Akathisia and second-generation antipsychotic drugs . Current Opinion in Psychiatry . 22 . 3 . 293–99 . May 2009 . 19378382 . 10.1097/YCO.0b013e32832a16da . 31506138 .
  85. Koh EH, Lee WJ, Lee SA, Kim EH, Cho EH, Jeong E, Kim DW, Kim MS, Park JY, Park KG, Lee HJ, Lee IK, Lim S, Jang HC, Lee KH, Lee KU . 6 . Effects of alpha-lipoic Acid on body weight in obese subjects . The American Journal of Medicine . 124 . 1 . 85.e1–8 . January 2011 . 21187189 . 10.1016/j.amjmed.2010.08.005 .
  86. Kim E, Park DW, Choi SH, Kim JJ, Cho HS . A preliminary investigation of alpha-lipoic acid treatment of antipsychotic drug-induced weight gain in patients with schizophrenia . Journal of Clinical Psychopharmacology . 28 . 2 . 138–46 . April 2008 . 18344723 . 10.1097/JCP.0b013e31816777f7 . 7873991 .
  87. Jariwalla RJ, Lalezari J, Cenko D, Mansour SE, Kumar A, Gangapurkar B, Nakamura D . Restoration of blood total glutathione status and lymphocyte function following alpha-lipoic acid supplementation in patients with HIV infection . Journal of Alternative and Complementary Medicine . 14 . 2 . 139–46 . March 2008 . 18315507 . 10.1089/acm.2006.6397 .
  88. Ritsner MS, Miodownik C, Ratner Y, Shleifer T, Mar M, Pintov L, Lerner V . L-theanine relieves positive, activation, and anxiety symptoms in patients with schizophrenia and schizoaffective disorder: an 8-week, randomized, double-blind, placebo-controlled, 2-center study . The Journal of Clinical Psychiatry . 72 . 1 . 34–42 . January 2011 . 21208586 . 10.4088/JCP.09m05324gre . 4937207 .
  89. Miodownik C, Maayan R, Ratner Y, Lerner V, Pintov L, Mar M, Weizman A, Ritsner MS . 6 . Serum levels of brain-derived neurotrophic factor and cortisol to sulfate of dehydroepiandrosterone molar ratio associated with clinical response to L-theanine as augmentation of antipsychotic therapy in schizophrenia and schizoaffective disorder patients . Clinical Neuropharmacology . 34 . 4 . 155–60 . 2011 . 21617527 . 10.1097/WNF.0b013e318220d8c6 . 9786949 .
  90. Lardner AL . Neurobiological effects of the green tea constituent theanine and its potential role in the treatment of psychiatric and neurodegenerative disorders . Nutritional Neuroscience . 17 . 4 . 145–55 . July 2014 . 23883567 . 10.1179/1476830513Y.0000000079 . 206849271 .
  91. Kelly SP, Gomez-Ramirez M, Montesi JL, Foxe JJ . L-theanine and caffeine in combination affect human cognition as evidenced by oscillatory alpha-band activity and attention task performance . The Journal of Nutrition . 138 . 8 . 1572S–1577S . August 2008 . 18641209 . 10.1093/jn/138.8.1572S . free .
  92. Park SK, Jung IC, Lee WK, Lee YS, Park HK, Go HJ, Kim K, Lim NK, Hong JT, Ly SY, Rho SS . 6 . A combination of green tea extract and l-theanine improves memory and attention in subjects with mild cognitive impairment: a double-blind placebo-controlled study . Journal of Medicinal Food . 14 . 4 . 334–43 . April 2011 . 21303262 . 10.1089/jmf.2009.1374 . 19296401 .
  93. Foxe JJ, Morie KP, Laud PJ, Rowson MJ, de Bruin EA, Kelly SP . Assessing the effects of caffeine and theanine on the maintenance of vigilance during a sustained attention task . Neuropharmacology . 62 . 7 . 2320–7 . June 2012 . 22326943 . 10.1016/j.neuropharm.2012.01.020 . 13232338 .
  94. Nobre AC, Rao A, Owen GN . L-theanine, a natural constituent in tea, and its effect on mental state . Asia Pacific Journal of Clinical Nutrition . 17 . 167–8 . 2008 . Suppl 1 . 18296328 .
  95. Di X, Yan J, Zhao Y, Chang Y, Zhao B . L-theanine inhibits nicotine-induced dependence via regulation of the nicotine acetylcholine receptor-dopamine reward pathway . Science China Life Sciences . 55 . 12 . 1064–74 . December 2012 . 23233221 . 10.1007/s11427-012-4401-0 . 17803427 . free .
  96. Meskanen K, Ekelund H, Laitinen J, Neuvonen PJ, Haukka J, Panula P, Ekelund J . A randomized clinical trial of histamine 2 receptor antagonism in treatment-resistant schizophrenia . Journal of Clinical Psychopharmacology . 33 . 4 . 472–8 . August 2013 . 23764683 . 10.1097/JCP.0b013e3182970490 . 13048121 .
  97. Atmaca M, Tezcan E, Kuloglu M, Ustundag B, Kirtas O . The effect of extract of ginkgo biloba addition to olanzapine on therapeutic effect and antioxidant enzyme levels in patients with schizophrenia . Psychiatry and Clinical Neurosciences . 59 . 6 . 652–6 . December 2005 . 16401239 . 10.1111/j.1440-1819.2005.01432.x . 1892988 . free .
  98. Doruk A, Uzun O, Ozşahin A . A placebo-controlled study of extract of ginkgo biloba added to clozapine in patients with treatment-resistant schizophrenia . International Clinical Psychopharmacology . 23 . 4 . 223–7 . July 2008 . 18545061 . 10.1097/YIC.0b013e3282fcff2f . 42478246 .
  99. Zhang XY, Zhou DF, Su JM, Zhang PY . The effect of extract of ginkgo biloba added to haloperidol on superoxide dismutase in inpatients with chronic schizophrenia . Journal of Clinical Psychopharmacology . 21 . 1 . 85–8 . February 2001 . 11199954 . 10.1097/00004714-200102000-00015 . 7836683 .
  100. Zhang XY, Zhou DF, Zhang PY, Wu GY, Su JM, Cao LY . A double-blind, placebo-controlled trial of extract of Ginkgo biloba added to haloperidol in treatment-resistant patients with schizophrenia . The Journal of Clinical Psychiatry . 62 . 11 . 878–83 . November 2001 . 11775047 . 10.4088/JCP.v62n1107 .
  101. Zhang XY, Zhou DF, Cao LY, Wu GY . The effects of Ginkgo biloba extract added to haloperidol on peripheral T cell subsets in drug-free schizophrenia: a double-blind, placebo-controlled trial . Psychopharmacology . 188 . 1 . 12–7 . September 2006 . 16906395 . 10.1007/s00213-006-0476-2 . 12411168 .
  102. Zhang WF, Tan YL, Zhang XY, Chan RC, Wu HR, Zhou DF . Extract of Ginkgo biloba treatment for tardive dyskinesia in schizophrenia: a randomized, double-blind, placebo-controlled trial . The Journal of Clinical Psychiatry . 72 . 5 . 615–21 . May 2011 . 20868638 . 10.4088/JCP.09m05125yel . 37085462 .
  103. Zhou D, Zhang X, Su J, Nan Z, Cui Y, Liu J, Guan Z, Zhang P, Shen Y . 6 . The effects of classic antipsychotic haloperidol plus the extract of ginkgo biloba on superoxide dismutase in patients with chronic refractory schizophrenia . Chinese Medical Journal . 112 . 12 . 1093–6 . December 1999 . 11721446 .
  104. Bennett AC, Vila TM . The role of ondansetron in the treatment of schizophrenia . The Annals of Pharmacotherapy . 44 . 7–8 . 1301–6 . July–August 2010 . 20516364 . 10.1345/aph.1P008 . 21574153 .
  105. Strous RD, Ritsner MS, Adler S, Ratner Y, Maayan R, Kotler M, Lachman H, Weizman A . 6 . Improvement of aggressive behavior and quality of life impairment following S-adenosyl-methionine (SAM-e) augmentation in schizophrenia . European Neuropsychopharmacology . 19 . 1 . 14–22 . January 2009 . 18824331 . 10.1016/j.euroneuro.2008.08.004 . 207712279 .
  106. Guidotti A, Ruzicka W, Grayson DR, Veldic M, Pinna G, Davis JM, Costa E . S-adenosyl methionine and DNA methyltransferase-1 mRNA overexpression in psychosis . NeuroReport . 18 . 1 . 57–60 . January 2007 . 17259861 . 10.1097/WNR.0b013e32800fefd7 . 25378736 .
  107. Dakhale GN, Khanzode SD, Khanzode SS, Saoji A . Supplementation of vitamin C with atypical antipsychotics reduces oxidative stress and improves the outcome of schizophrenia . Psychopharmacology . 182 . 4 . 494–8 . November 2005 . 16133138 . 10.1007/s00213-005-0117-1 . 24917071 .
  108. Wang Y, Liu XJ, Robitaille L, Eintracht S, MacNamara E, Hoffer LJ . Effects of vitamin C and vitamin D administration on mood and distress in acutely hospitalized patients . The American Journal of Clinical Nutrition . 98 . 3 . 705–11 . September 2013 . 23885048 . 10.3945/ajcn.112.056366 . free .
  109. Zhang M, Robitaille L, Eintracht S, Hoffer LJ . Vitamin C provision improves mood in acutely hospitalized patients . Nutrition . 27 . 5 . 530–3 . May 2011 . 20688474 . 10.1016/j.nut.2010.05.016 .
  110. Kennedy DO, Veasey R, Watson A, Dodd F, Jones E, Maggini S, Haskell CF . Effects of high-dose B vitamin complex with vitamin C and minerals on subjective mood and performance in healthy males . Psychopharmacology . 211 . 1 . 55–68 . July 2010 . 20454891 . 2885294 . 10.1007/s00213-010-1870-3 .
  111. Moran M . Psychosocial Treatment Often Missing From Schizophrenia Regimens . Psychiatric News. 18 November 2005. 40 . 22. 24–37 . 10.1176/pn.40.22.0024b.
  112. Jones C, Cormac I, Silveira da Mota Neto JI, Campbell C . Cognitive behaviour therapy for schizophrenia . The Cochrane Database of Systematic Reviews . 4 . CD000524 . October 2004 . 15495000 . 10.1002/14651858.CD000524.pub2 . Jones C .
  113. Wykes T, Steel C, Everitt B, Tarrier N . Cognitive behavior therapy for schizophrenia: effect sizes, clinical models, and methodological rigor . Schizophrenia Bulletin . 34 . 3 . 523–37 . May 2008 . 17962231 . 2632426 . 10.1093/schbul/sbm114 .
  114. Zimmermann G, Favrod J, Trieu VH, Pomini V . The effect of cognitive behavioral treatment on the positive symptoms of schizophrenia spectrum disorders: a meta-analysis . Schizophrenia Research . 77 . 1 . 1–9 . September 2005 . 16005380 . 10.1016/j.schres.2005.02.018 . 31560136 .
  115. Lynch D, Laws KR, McKenna PJ . Cognitive behavioural therapy for major psychiatric disorder: does it really work? A meta-analytical review of well-controlled trials . Psychological Medicine . 40 . 1 . 9–24 . January 2010 . 19476688 . 10.1017/s003329170900590x . 1001891 . free . 2299/5741 . free .
  116. Newton‐Howes, Giles and Rebecca Wood. "Cognitive behavioural therapy and the psychopathology of schizophrenia: Systematic review and meta‐analysis." Psychology and Psychotherapy: Theory, Research and Practice (2011).
  117. Jones C, Hacker D, Meaden A, Cormac I, Irving CB . WITHDRAWN: Cognitive behaviour therapy versus other psychosocial treatments for schizophrenia . The Cochrane Database of Systematic Reviews . 4 . CD000524 . April 2011 . 21491377 . 10.1002/14651858.cd000524.pub3 .
  118. Wykes T, Brammer M, Mellers J, Bray P, Reeder C, Williams C, Corner J . Effects on the brain of a psychological treatment: cognitive remediation therapy: functional magnetic resonance imaging in schizophrenia . The British Journal of Psychiatry . 181 . 144–52 . August 2002 . 12151286 . 10.1192/bjp.181.2.144 . 221295938 . free .
  119. Moritz S, Woodward TS . Metacognitive training in schizophrenia: from basic research to knowledge translation and intervention . Current Opinion in Psychiatry . 20 . 6 . 619–25 . November 2007 . 17921766 . 10.1097/YCO.0b013e3282f0b8ed . 3193086 .
  120. Moritz S, Woodward TS, Burlon M . 2005. Metacognitive skill training for patients with schizophrenia (MCT) . VanHam Campus. Hamburg . 1 April 2011 .
  121. Bell V, Halligan PW, Ellis HD . Explaining delusions: a cognitive perspective . Trends in Cognitive Sciences . 10 . 5 . 219–26 . May 2006 . 16600666 . 10.1016/j.tics.2006.03.004 . 24541273 .
  122. Moritz S, Woodward TS . 2007 . Metacognitive training for schizophrenia patients (MCT): A pilot study on feasibility, treatment adherence, and subjective efficacy . German Journal of Psychiatry . 10 . 69–78 . 2011-04-01 . https://web.archive.org/web/20160305084414/http://www.gjpsy.uni-goettingen.de/gjp-article-moritz3.pdf . 2016-03-05 . dead .
  123. Pankowski D, Kowalski J, Gawęda Ł . The effectiveness of metacognitive training for patients with schizophrenia: a narrative systematic review of studies published between 2009 and 2015 . pl . Psychiatria Polska . 50 . 4 . 787–803 . 2016 . 27847929 . 10.12740/pp/59113 . free .
  124. Eichner C, Berna F . Acceptance and Efficacy of Metacognitive Training (MCT) on Positive Symptoms and Delusions in Patients With Schizophrenia: A Meta-analysis Taking Into Account Important Moderators . Schizophrenia Bulletin . 42 . 4 . 952–62 . July 2016 . 26748396 . 4903058 . 10.1093/schbul/sbv225 .
  125. Kowalski J, Pankowski D, Lew-Starowicz M, Gawęda Ł . 2017-07-03. Do specific metacognitive training modules lead to specific cognitive changes among patients diagnosed with schizophrenia? A single module effectiveness pilot study . Psychosis. 9. 3. 254–259. 10.1080/17522439.2017.1300186. 151353395. 1752-2439.
  126. Moritz S, Veckenstedt R, Randjbar S, Vitzthum F (in press). "Individualized metacognitive therapy for people with schizophrenia psychosis (MCT+)", Springer, Heidelberg.
  127. McFarlane WR, Dixon L, Lukens E, Lucksted A . Family psychoeducation and schizophrenia: a review of the literature . Journal of Marital and Family Therapy . 29 . 2 . 223–45 . April 2003 . 12728780 . 10.1111/j.1752-0606.2003.tb01202.x .
  128. Glynn SM, Cohen AN, Niv N . New challenges in family interventions for schizophrenia . Expert Review of Neurotherapeutics . 7 . 1 . 33–43 . January 2007 . 17187495 . 10.1586/14737175.7.1.33 . 25863992 .
  129. Pharoah F, Mari J, Rathbone J, Wong W . Family intervention for schizophrenia . The Cochrane Database of Systematic Reviews . 12 . CD000088 . December 2010 . 21154340 . 4204509 . 10.1002/14651858.CD000088.pub2 . Pharoah F .
  130. Book: Jones S, Hayward P . Coping with Schizophrenia: A Guide for Patients, Families and Caregivers . Oneworld Pub. . 2004 . Oxford, England . 978-1-85168-344-4 . registration .
  131. Book: Torrey EF . E. Fuller Torrey . Surviving Schizophrenia: A Manual for Families, Consumers, and Providers . HarperCollins . 2006 . 978-0-06-084259-8. 5th .
  132. Kopelowicz A, Liberman RP, Zarate R . Recent advances in social skills training for schizophrenia . Schizophrenia Bulletin . 32 . Suppl 1 . S12-23 . October 2006 . 16885207 . 2632540 . 10.1093/schbul/sbl023 .
  133. Talwar N, Crawford MJ, Maratos A, Nur U, McDermott O, Procter S . Music therapy for in-patients with schizophrenia: exploratory randomised controlled trial . The British Journal of Psychiatry . 189 . 5 . 405–9 . November 2006 . 17077429 . 10.1192/bjp.bp.105.015073 . free .
  134. Ruddy R, Milnes D . Art therapy for schizophrenia or schizophrenia-like illnesses . The Cochrane Database of Systematic Reviews . 4 . CD003728 . October 2005 . 16235338 . 10.1002/14651858.CD003728.pub2 . Ruddy R .
  135. Ruddy RA, Dent-Brown K . Drama therapy for schizophrenia or schizophrenia-like illnesses . The Cochrane Database of Systematic Reviews . 1 . CD005378 . January 2007 . 17253555 . 10.1002/14651858.CD005378.pub2 . Ruddy R .
  136. Mosher LR . Soteria and other alternatives to acute psychiatric hospitalization: a personal and professional review . The Journal of Nervous and Mental Disease . 187 . 3 . 142–9 . March 1999 . 10086470 . 10.1097/00005053-199903000-00003 .
  137. Calton T, Ferriter M, Huband N, Spandler H . A systematic review of the Soteria paradigm for the treatment of people diagnosed with schizophrenia . Schizophrenia Bulletin . 34 . 1 . 181–92 . January 2008 . 17573357 . 2632384 . 10.1093/schbul/sbm047 .
  138. Book: Bartholomeusz C . Handbook of Schizophrenia Spectrum Disorders, Volume III: Therapeutic Approaches, Comorbidity, and Outcomes. 2011. Springer. 9789400708341. 189.
  139. Aali G, Kariotis T, Shokraneh F . Avatar Therapy for people with schizophrenia or related disorders . The Cochrane Database of Systematic Reviews . 2020 . CD011898 . May 2020 . 5 . 32413166 . 7387758 . 10.1002/14651858.CD011898.pub2 .
  140. Ng QX, Soh AY, Venkatanarayanan N, Ho CY, Lim DY, Yeo WS . A Systematic Review of the Effect of Probiotic Supplementation on Schizophrenia Symptoms . Neuropsychobiology . 78 . 1 . 1–6 . 2019 . 30947230 . 10.1159/000498862 . free .
  141. Patrick RP, Ames BN . Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior . FASEB Journal . 29 . 6 . 2207–22 . June 2015 . 25713056 . 10.1096/fj.14-268342 . free . 2368912 .
  142. Lim SY, Kim EJ, Kim A, Lee HJ, Choi HJ, Yang SJ . Nutritional Factors Affecting Mental Health . Clinical Nutrition Research . 5 . 3 . 143–52 . July 2016 . 27482518 . 4967717 . 10.7762/cnr.2016.5.3.143 .
  143. Bosnjak Kuharic D, Kekin I, Hew J, Rojnic Kuzman M, Puljak L . Interventions for prodromal stage of psychosis . The Cochrane Database of Systematic Reviews . 2019 . 11 . November 2019 . 31689359 . 6823626 . 10.1002/14651858.CD012236.pub2 .
  144. Elkis H, Buckley PF . Treatment-Resistant Schizophrenia . The Psychiatric Clinics of North America . 39 . 2 . 239–65 . June 2016 . 27216902. 10.1016/j.psc.2016.01.006.
  145. Siskind D, Siskind V, Kisely S . Clozapine Response Rates among People with Treatment-Resistant Schizophrenia: Data from a Systematic Review and Meta-Analysis . Canadian Journal of Psychiatry . 62 . 11 . 772–777 . November 2017 . 28655284. 10.1177/0706743717718167. 5697625 .
  146. . 208792724 . Schizophrenia . Lancet . 374 . 9690 . 635–45 . August 2009 . 19700006 . 10.1016/S0140-6736(09)60995-8 . https://web.archive.org/web/20130623065810/http://xa.yimg.com/kq/groups/19525360/611943554/name/Schizophrenia+-+The+Lancet.pdf . dmy-all . dead . 23 June 2013 . 23 December 2011 .
  147. Picchioni MM, Murray RM . Schizophrenia . BMJ . 335 . 7610 . 91–5 . July 2007 . 17626963 . 1914490 . 10.1136/bmj.39227.616447.BE .
  148. Essali A, Al-Haj Haasan N, Li C, Rathbone J . Clozapine versus typical neuroleptic medication for schizophrenia . The Cochrane Database of Systematic Reviews . 1 . CD000059 . January 2009 . 2009 . 19160174 . 10.1002/14651858.CD000059.pub2 . 7065592 .
  149. Gillespie AL, Samanaite R, Mill J, Egerton A, MacCabe JH . Is treatment-resistant schizophrenia categorically distinct from treatment-responsive schizophrenia? a systematic review . BMC Psychiatry . 17 . 1 . 12 . 13 January 2017 . 28086761 . 10.1186/s12888-016-1177-y. 5237235 . free .
  150. Potkin SG, Kane JM, Correll CU. etal. The neurobiology of treatment-resistant schizophrenia: paths to antipsychotic resistance and a roadmap for future research . npj Schizophrenia . 6 . 1 . 1 . 7 January 2020 . 31911624 . 10.1038/s41537-019-0090-z. 6946650 .
  151. Sinclair DJ, Zhao S, Qi F . etal . Electroconvulsive therapy for treatment-resistant schizophrenia. . The Cochrane Database of Systematic Reviews . 2019 . CD011847 . 19 March 2019 . 3 . 30888709. 10.1002/14651858.CD011847.pub2. 6424225 .
  152. Miyamoto S, Jarskog LF, Fleischhacker WW . New therapeutic approaches for treatment-resistant schizophrenia: a look to the future . Journal of Psychiatric Research . 58 . 1–6 . November 2014. 25070124. 10.1016/j.jpsychires.2014.07.001 .
  153. Sriretnakumar V, Huang E, Müller DJ . 207492339 . Pharmacogenetics of clozapine treatment response and side-effects in schizophrenia: an update . Expert Opinion on Drug Metabolism & Toxicology . 2015 . 11 . 11 . 1709–31 . 10.1517/17425255.2015.1075003 . 26364648.
  154. Agarwal P, Sarris CE, Herschman Y, Agarwal N, Mammis A . 6929780 . Schizophrenia and neurosurgery: A dark past with hope of a brighter future . Journal of Clinical Neuroscience . 34 . 53–58 . December 2016 . 10.1016/j.jocn.2016.08.009 . 27634495.
  155. Servonnet A, Samaha AN . 147704473 . Antipsychotic-evoked dopamine supersensitivity . Neuropharmacology . 163 . 107630 . February 2020 . 31077727. 10.1016/j.neuropharm.2019.05.007.
  156. Nucifora FC, Woznica E, Lee BJ, Cascella N, Sawa A . Treatment resistant schizophrenia: Clinical, biological, and therapeutic perspectives. . Neurobiology of Disease . 131 . 104257 . November 2019 . 30170114. 10.1016/j.nbd.2018.08.016. 6395548 .
  157. Web site: Skitsofreniapotilaiden tuettu työllistyminen . 2023-04-03 . www.kaypahoito.fi.
  158. Richter . D. . Hoffmann . H. . September 2017 . Independent housing and support for people with severe mental illness: systematic review . Acta Psychiatrica Scandinavica . 136 . 3 . 269–279 . 10.1111/acps.12765 . 1600-0447 . 28620944. 32054475 .
  159. McPherson . Peter . Krotofil . Joanna . Killaspy . Helen . 2018-05-15 . Mental health supported accommodation services: a systematic review of mental health and psychosocial outcomes . BMC Psychiatry . 18 . 1 . 128 . 10.1186/s12888-018-1725-8 . 1471-244X . 5952646 . 29764420 . free .
  160. Shen X, Xia J, Adams CE . Acupuncture for schizophrenia . The Cochrane Database of Systematic Reviews . 10 . CD005475 . October 2014 . 2014 . 25330045 . 4193731 . 10.1002/14651858.CD005475.pub2 .
  161. van den Noort M, Yeo S, Lim S, Lee SH, Staudte H, Bosch P . Acupuncture as Add-On Treatment of the Positive, Negative, and Cognitive Symptoms of Patients with Schizophrenia: A Systematic Review . Medicines . 5 . 2 . 29 . March 2018 . 29601477 . 6023351 . 10.3390/medicines5020029 . free .
  162. Deng H, Xu J . Wendan decoction (Traditional Chinese medicine) for schizophrenia . The Cochrane Database of Systematic Reviews . 2017 . CD012217 . June 2017 . 6 . 28657646 . 6481906 . 10.1002/14651858.CD012217.pub2 .
  163. Wieland LS, Santesso N . Summary of a Cochrane review: Wendan decoction traditional Chinese medicine for schizophrenia . European Journal of Integrative Medicine . 15 . 81–82 . October 2017 . 29062436 . 5649251 . 10.1016/j.eujim.2017.09.009 .
  164. Pinault D . A Neurophysiological Perspective on a Preventive Treatment against Schizophrenia Using Transcranial Electric Stimulation of the Corticothalamic Pathway . Brain Sciences . 7 . 4 . 34 . March 2017 . 28350371 . 5406691 . 10.3390/brainsci7040034 . free .
  165. Nathou C, Etard O, Dollfus S . Auditory verbal hallucinations in schizophrenia: current perspectives in brain stimulation treatments . Neuropsychiatric Disease and Treatment . 15 . 2105–2117 . 2019 . 31413576 . 6662171 . 10.2147/NDT.S168801 . free .
  166. Greenhalgh J, Knight C, Hind D, Beverley C, Walters S . Clinical and cost-effectiveness of electroconvulsive therapy for depressive illness, schizophrenia, catatonia and mania: systematic reviews and economic modelling studies . Health Technology Assessment . 9 . 9 . 1–156, iii–iv . March 2005 . 15774232 . 10.3310/hta9090 . free .
  167. Web site: The clinical effectiveness and cost effectiveness of electroconvulsive Therapy (ECT) for depressive illness, schizophrenia, catatonia and mania. 2007-06-17 . National Institute for Health and Clinical Excellence. April 2003 . National Institute for Health and Clinical Excellence.
  168. Mashour GA, Walker EE, Martuza RL . Psychosurgery: past, present, and future . Brain Research. Brain Research Reviews . 48 . 3 . 409–19 . June 2005 . 15914249 . 10.1016/j.brainresrev.2004.09.002 . 10303872 .
  169. Laupu WK . The efficacy of Garcinia mangostana L. (mangosteen) pericarp as an adjunctive to second-generation antipsychotics for the treatment of schizophrenia: a double blind, randomised, placebo-controlled trial. 2014. April 24, 2017. James Cook University. 40097. phd.
  170. Helman DS. 2018. Recovery from schizophrenia: An autoethnography. Deviant Behavior. 39. 3. 380–399. 10.1080/01639625.2017.1286174. 151705012.
  171. Tyrer P . Nidotherapy: a cost-effective systematic environmental intervention . World Psychiatry . 18 . 2 . 144–145 . June 2019 . 31059613 . 6502418 . 10.1002/wps.20622 .
  172. Ruddle A, Mason O, Wykes T . A review of hearing voices groups: evidence and mechanisms of change . Clin Psychol Rev . 31 . 5 . 757–66 . July 2011 . 21510914 . 10.1016/j.cpr.2011.03.010 .
  173. Corstens D, Longden E, McCarthy-Jones S, Waddingham R, Thomas N . Emerging perspectives from the hearing voices movement: implications for research and practice . Schizophr Bull . 40 . Suppl 4. S285–94 . July 2014 . 24936088 . 4141309 . 10.1093/schbul/sbu007 .
  174. Chien WT, Clifton AV, Zhao S, Lui S . Peer support for people with schizophrenia or other serious mental illness . The Cochrane Database of Systematic Reviews . 4 . 6. CD010880 . April 2019 . 30946482 . 6448529 . 10.1002/14651858.CD010880.pub2 . Cochrane Schizophrenia Group .

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