Pharmacological Treatment of Schizophrenia: Japanese Expert Consensus

Hitoshi Sakurai; Norio Yasui-Furukori; Takefumi Suzuki; Hiroyuki Uchida; Hajime Baba; Koichiro Watanabe; Ken Inada; Yuka Sugawara Kikuchi; Toshiaki Kikuchi; Asuka Katsuki; Ikuko Kishida; Masaki Kato

doi:10.1055/a-1324-3517

Pharmacopsychiatry, Table of Contents

CC BY-NC-ND 4.0 · Pharmacopsychiatry 2021; 54(02): 60-67
DOI: 10.1055/a-1324-3517

Original Paper

Pharmacological Treatment of Schizophrenia: Japanese Expert Consensus

Hitoshi Sakurai

¹Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

²Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan

,

Norio Yasui-Furukori

³Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan

,

Takefumi Suzuki

⁴Department of Neuropsychiatry, University of Yamanashi Faculty of Medicine, Yamanashi, Japan

,

Hiroyuki Uchida

²Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan

,

Hajime Baba

⁵Department of Psychiatry & Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan

,

Koichiro Watanabe

⁶Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan

,

Ken Inada

⁷Department of Psychiatry, Tokyo Women’s Medical University School of Medicine, Tokyo Japan

,

Yuka Sugawara Kikuchi

⁸Department of Psychiatry, Akita University School of Medicine, Akita, Japan

,

Toshiaki Kikuchi

²Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan

,

Asuka Katsuki

⁹Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan

,

Ikuko Kishida

¹⁰Fujisawa Hospital, Kanagawa, Japan

¹¹Department of Psychiatry, Yokohama City University School of Medicine, Kanagawa, Japan

,

Masaki Kato

¹²Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan

› Author Affiliations

Abstract

Introduction Conventional treatment guidelines of schizophrenia do not necessarily provide solutions on clinically important issues.

Methods A total of 141 certified psychiatrists of the Japanese Society of Clinical Neuropsychopharmacology evaluated treatment options regarding 19 clinically relevant situations in the treatment of schizophrenia with a 9-point scale (1=“disagree” and 9=“agree”).

Results First-line antipsychotics varied depending on predominant symptoms: risperidone (mean±standard deviation score, 7.9±1.4), olanzapine (7.5±1.6), and aripiprazole (6.9±1.9) were more likely selected for positive symptoms; aripiprazole (7.6±1.6) for negative symptoms; aripiprazole (7.3±1.9), olanzapine (7.2±1.9), and quetiapine (6.9±1.9) for depression and anxiety; and olanzapine (7.9±1.5) and risperidone (7.5±1.5) for excitement and aggression. While only aripiprazole was categorized as a first-line treatment for relapse prevention (7.6±1.0) in patients without noticeable symptoms, aripiprazole (8.0±1.6) and brexpiprazole (6.9±2.3) were categorized as such for social integration. First-line treatments in patients who are vulnerable to extrapyramidal symptoms include quetiapine (7.5±2.0) and aripiprazole (6.9±2.1).

Discussion These clinical recommendations represent the expert consensus on the use of a particular antipsychotic medication for a particular situation, filling a current gap in the literature.

Key words

antipsychotics - expert consensus - pharmacotherapy - schizophrenia

Full Text

References

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Supplementary Material

Supplementary Material