World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, Part 1: Update 2012 on the acute treatment of schizophrenia and the management of treatment resistance

Abstract

These updated guidelines are based on a first edition of the World Federation of Societies of Biological Psychiatry Guidelines for Biological Treatment of Schizophrenia published in 2005. For this 2012 revision, all available publications pertaining to the biological treatment of schizophrenia were reviewed systematically to allow for an evidence-based update. These guidelines provide evidence-based practice recommendations that are clinically and scientifically meaningful and these guidelines are intended to be used by all physicians diagnosing and treating people suffering from schizophrenia. Based on the first version of these guidelines, a systematic review of the MEDLINE/PUBMED database and the Cochrane Library, in addition to data extraction from national treatment guidelines, has been performed for this update. The identified literature was evaluated with respect to the strength of evidence for its efficacy and then categorised into six levels of evidence (A–F; Bandelow et al. 2008b, World J Biol Psychiatry 9:242). This first part of the updated guidelines covers the general descriptions of antipsychotics and their side effects, the biological treatment of acute schizophrenia and the management of treatment-resistant schizophrenia.

Key words::

• Schizophrenia
• antipsychotics
• evidence-based guidelines
• treatment
• acute phase treatment
• treatment resistance
• biological treatment

Acknowledgements

We would like to thank Daniela Reich-Erkelenz, Department of Psychiatry, Georg-August-University Goettingen, for general and editorial assistance in preparing these guidelines and we would like to thank Louise Marshall, University College London, for supporting the manuscript editing. The draft version of the guidelines was sent to all presidents of the various national societies of biological psychiatry that are members of the WFSBP; our thanks go to those presidents who sent us their comments on the guidelines.

Statement of Interest

Alkomiet Hasan has been invited to scientific meetings by Lundbeck, Janssen-Cilag and Pfizer. Peter Falkai was honorary speaker for Janssen-Cilag, Astra-Zeneca, Eli Lilly, Bristol Myers-Squibb, Lundbeck, Pfizer, Bayer Vital, SmithKline Beecham, Wyeth, and Essex. During the last 2 years, but not presently, Peter Falkai was a member of the advisory boards of Janssen-Cilag, AstraZeneca, Eli Lilly, and Lundbeck. He received research support by AstraZeneca. Thomas Wobrock has been a member of a speaker bureau for Alpine Biomed, AstraZeneca, Bristol Myers Squibb, Eli Lilly, I3G, Janssen-Cilag, Novartis, Lundbeck, Sanofi-Aventis and Pfizer. He received research support by AstraZeneca, I3G and AOK. Jeffrey Liebermann was/is a member of the advisory boards of Bioline, Intracellular Therapies, Alkermes, Lilly and Pierre Fabre. He received research support/grants by Allon, GlaxoSmithKline, Lilly, Merck, Novartis, Pfizer, Psychogenics, LTD, Sepracor and Targacept. He holds a patent by Repligen. Birte Glenthoj and Wagner F. Gattatz report no conflict of interest. Florence Thibaut is a member of the Sertindol Study International Safety Committee. Hans-Jürgen Möller has received grants or is a consultant for and on the speakership bureaus of AstraZeneca, Bristol-Meyers Squibb, Eisai, Eli Lilly, GlaxoSmithKline, Janssen Cilag, Lundbeck, Merck, Norvartis, Organon, Pfizer, Sanofi-Aventis, Schering-Plough, Schwabe, Sepracor, Servier and Wyeth.