1 February 2003
Singapore Ministry of Health - National Government Agency [Non-U.S.]
Summary,

GUIDELINE OBJECTIVE(S)

* To provide guidance to doctors on the many treatment options available for schizophrenia, based on the best available evidence from the medical literature
* To provide patients with schizophrenia with the best possible care and outcome
* To assist primary health care physicians in clinical decision-making

TARGET POPULATION

Adults with schizophrenia in Singapore

INTERVENTIONS AND PRACTICES CONSIDERED

Diagnosis and Assessment

1. Assessment of patient for symptoms of schizophrenia, co-morbid psychiatric illness, co-morbid medical condition, or substance abuse
2. Evaluation of patient's social supports, functioning, and relative risk of self-harm or harm to others

Treatment

1. Pharmacotherapy
* First-line antipsychotic medications (trifluoperazine, chlorpromazine, thioridazine, haloperidol, sulpiride)
* Second-line antipsychotic medications (clozapine, risperidone, olanzapine, quetiapine, amisulpride)
* Depot antipsychotic medications
* Maintenance and discontinuation of antipsychotics
* Adjunctive medications, including anticholinergic agents, benzodiazepines, mood stabilizers (e.g., lithium, carbamazepine, valproate), and antidepressants
* Monitoring of response to medications and adjustments as necessary
2. Electroconvulsive therapy (ECT)
3. Psychosocial interventions
* Individual and group psychological therapy
* Psychoeducation/family intervention
* Social skills training
* Vocational training
4. Referral to psychiatrist

MAJOR OUTCOMES CONSIDERED

* Effectiveness and safety of medications
* Side effects, adverse effects, and costs of treatment
* Rates of relapse, coping skills, social and vocational functioning, and ability to function independently