Optimizing outcomes for persons with schizophrenia minimizing adverse effects and individualizing treatment

摘要

Most clinical trials that guide anttosychotic treatment of schizophrenia are conducted in Western countries and their lessons are often blithely applied across the world. There are significant ethnic and individual differences in pharmacology (Wong and Pi, 2012) and side-effect vulnerabilities that warrant consideration, however, and suggest the need for carefully evaluating such differences and call for the provision of measurement-based care (Tandon et al., 2006). Whereas all antipsychotics are about equally efficacious in the treatment of schizophrenia (with the exception of clozapine), they differ very significantly in their side-effect profiles (Tandon, 2011). Rational antipsychotic treatment therefore requires a good understanding of how different antipsychotics compare and what factors might predict variability in individual response. Two papers in this issue of the Journal address the two major adverse effects associated with antipsychotic treatment - metabolic syndrome (Kumar et al.) and motor side-effects (specifically tardive syndromes, Hazari et al.).