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Korean J Schizophr Res > Volume 22(2); 2019 > Article
Korean Journal of Schizophrenia Research 2019;22(2):21-33.
DOI: https://doi.org/10.16946/kjsr.2019.22.2.21    Published online October 31, 2019.
Korean Treatment Guideline on Pharmacotherapy of Co-existing Symptoms and Antipsychotics-related Side Effects in Patients with Schizophrenia.
Je Yeon Yun, Jung Suk Lee, Shi Hyun Kang, Beomwoo Nam, Seung Jae Lee, Seung Hwan Lee, Joonho Choi, Chan Hyung Kim, Young Chul Chung
1Seoul National University Hospital, Seoul, Korea.
2Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Korea.
3Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
4Adult Psychiatry, Division of Medical Services, National Center for Mental Health, Seoul, Korea.
5Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea.
6Department of Psychiatry, School of Medicine, Kyoungpook National University, Daegu, Korea.
7Department of Psychiatry, Inje University, Ilsan-Paik Hospital, Goyang, Korea.
8Department of Psychiatry, Hanyang University Guri Hospital, Guri, Korea.
9Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea.
10Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Korea. chungyc@jbnu.ac.kr
Abstract
OBJECTIVES
The current study covers a secondary revision of the guidelines for the pharmacotherapy of schizophrenia issued by the Korean Medication Algorithm for Schizophrenia (KMAP-SCZ) 2001, specifically for co-existing symptoms and antipsychotics-related side-effects in schizophrenia patients.
METHODS
An expert consensus regarding the strategies of pharmacotherapy for positive symptoms of schizophrenia, co-existing symptoms of schizophrenia, and side-effect of antipsychotics in patients with schizophrenia was retrieved by responses obtained using a 30-item questionnaire.
RESULTS
For the co-existing symptoms, agitation could be treated with oral or intramuscular injection of benzodiazepine or antipsychotics; depressive symptoms with atypical antipsychotics and adjunctive use of antidepressant; obsessive-compulsive symptoms with selective serotonin reuptake inhibitors and antipsychotics other than clozapine and olanzapine; negative symptoms with atypical antipsychotics or antidepressants; higher risk of suicide with clozapine; comorbid substance abuse with use of naltrexone or bupropion/ varenicline, respectively. For the antipsychotics-related side effects, anticholinergics (extrapyramidal symptom), propranolol and benzodiazepine (akathisia), topiramate or metformin (weight gain), change of antipsychotics to aripiprazole (hyperprolactinemia and prolonged QTc) or clozapine (tardive dyskinesia) could be used.
CONCLUSION
Updated pharmacotherapy strategies for co-existing symptoms and antipsychotics-related side effects in schizophrenia patients as presented in KMAP-SCZ 2019 could help effective clinical decision making of psychiatrists as a preferable option.
Key Words: Antipsychotics-related Side effects · Co-existing symptoms · Schizophrenia · 2019 Korean Medication Algorithm for Schizophrenia


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