Korean Journal of Schizophrenia Research (대한조현병학회지)

Korean Society for Schizophrenia Research (대한조현병학회)
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Korean Treatment Guideline on Pharmacotherapy of Co-existing Symptoms and Antipsychotics-related Side Effects in Patients with Schizophrenia

'2019 한국형 조현병 약물치료 지침서'에 따른 조현병에서 동반증상 및 부작용의 치료

  • Yun, Je-Yeon (Seoul National University Hospital) ;
  • Lee, Jung Suk (Department of Psychiatry, National Health Insurance Service Ilsan Hospital) ;
  • Kang, Shi Hyun (Adult Psychiatry, Division of Medical Services, National Center for Mental Health) ;
  • Nam, Beomwoo (Department of Psychiatry, School of Medicine, Konkuk University) ;
  • Lee, Seung Jae (Department of Psychiatry, School of Medicine, Kyoungpook National University) ;
  • Lee, Seung-Hwan (Department of Psychiatry, Inje University, Ilsan-Paik Hospital) ;
  • Choi, Joonho (Department of Psychiatry, Hanyang University Guri Hospital) ;
  • Kim, Chan-Hyung (Institute of Behavioral Science in Medicine, Yonsei University College of Medicine) ;
  • Chung, Young-Chul (Department of Psychiatry, Chonbuk National University Medical School)
  • 윤제연 (서울대학교병원 교육인재개발실) ;
  • 이정석 (국민건강보험공단 일산병원 정신건강의학과) ;
  • 강시현 (국립정신건강센터 성인정신과) ;
  • 남범우 (건국대학교 의학전문대학원 정신건강의학교실) ;
  • 이승재 (경북대학교 의과대학 정신건강의학교실) ;
  • 이승환 (인제대학교 의과대학 정신건강의학교실) ;
  • 최준호 (한양대학교 구리병원 정신건강의학과) ;
  • 김찬형 (연세대학교 의과대학 정신건강의학교실) ;
  • 정영철 (전북대학교 의과대학 정신건강의학교실)
  • Received : 2019.08.04
  • Accepted : 2019.09.03
  • Published : 2019.10.30
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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.

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