Schizophrenia Clinical Practice Guidelines (APA, 2020)

American Psychiatric Association

This is a quick summary of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

October 02, 2020

Guidelines for treating patients with schizophrenia were published in September 2020 by the American Psychiatric Association (APA).[1]

Assessment and Determination of Treatment Plan

The APA recommends a thorough initial assessment that includes the following components:

  • Reason patient is presenting

  • Patient's goals/preferences for treatment

  • Psychiatric symptoms

  • Trauma history

  • Tobacco/substance use

  • Psychiatric treatment history

  • Physical health

  • Mental status/cognitive assessment

  • Suicidality

  • Aggressive behaviors

The APA also recommends an initial psychiatric evaluation and a documented, comprehensive, and person-centered treatment plan.

Pharmacotherapy

The APA recommends treating schizophrenic patients with antipsychotic medication and monitoring effectiveness and side effects. If a patient's symptoms improve with antipsychotics, the APA recommends continuing the same medication. 

The APA recommends that treatment-resistant patients be treated with clozapine. This recommendation also applies to patients at substantial risk of suicide or suicide attempts as well as those at substantial risk of aggressive behavior despite other treatments.

The APA recommends that patients with acute dystonia associated with antipsychotic therapy be treated with an anticholinergic medication.

Psychosocial Interventions

The APA recommends patients with schizophrenia be treated with cognitive-behavioral therapy for psychosis and receive psychoeducation, supported employment services, social skills training, and cognitive remediation, among other services.

For more Clinical Practice Guidelines, go to Guidelines.

For more information, go to Schizophrenia.

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