Treatment as Prevention: Improving the Outcome of Schizophrenia-View Presentation

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Video Summary

In a webinar moderated by Dr. Vishal Madan from the American Psychiatric Association, Dr. Oliver Freudenreich, co-director of the MGH Psychosis Clinical and Research Program, discussed advances in preventing and treating schizophrenia. He emphasized a stage-based care model, prioritizing early intervention to prevent disease progression and utilizing treatments like long-acting injectables and clozapine effectively. <br /><br />Freudenreich highlighted that about 20-30% of schizophrenia patients do not respond to first-line treatments, suggesting these cases are often biologically treatment-resistant. He advocated for timely trials of clozapine and highlighted the underutilization of long-acting injectables, which could significantly reduce relapse and mortality rates.<br /><br />The webinar also addressed the importance of managing metabolic side effects from antipsychotics, recommending primary interventions like metformin and newer options like GLP-1 agonists to combat weight gain. Freudenreich underscored the necessity of integrating psychiatric and medical care, pointing out that many deaths in schizophrenia patients are from natural causes rather than suicide.<br /><br />In light of recent changes, the session included discussion on the FDA no longer requiring participation in the REMS program for dispensing clozapine, a move anticipated to facilitate increased usage of this critical drug. <br /><br />The presentation ended with reflections on the broader challenges related to societal conditions, access to care, and advocacy, urging professionals to remain active in improving patient outcomes and addressing public health disparities.

Keywords

schizophrenia

stage-based care

early intervention

long-acting injectables

clozapine

treatment-resistant

metabolic side effects

antipsychotics

GLP-1 agonists

integrated care

REMS program

public health disparities

patient outcomes