Latest News

Latest News

Resource Spotlight: Schizophrenia

March 21, 2023
Written byMaria Ahmed
This article was written and researched by a CSHP student member for Interactions, our biweekly newsletter. Crafting these pieces not only helps students gain in-depth knowledge of specific conditions, treatments, and resources, it also helps them hone their skills in research, critical appraisal, evaluation, synthesis, and writing – all of which will serve them well in clinical practice. The Professional Practice Team works with the student to select topics that are of interest and utility to both the student and to you, the reader. We hope you enjoy this piece by one of our future colleagues! Let us know what you think: If you would like to provide any comments or constructive feedback for our students, please email us at


Schizophrenia is a mental disorder that can negatively alter the trajectory of an individual’s emotional, cognitive, and social development and manifest in adolescence. The course of schizophrenia can vary among individuals, but symptoms can range from hallucinations and delusions to reduced expression and cognitive impairment. This “Resource Spotlight” contains links to associations, guidelines, and foundations that help pharmacists learn about the schizophrenia spectrum and its management, and additional resources required to support patients. To get a summary of schizophrenia, check out CSHP’s recent Clinical Pearls article on Schizophrenia: An Overview

External Resources  

Unless otherwise noted, the Canadian Society of Hospital Pharmacists (CSHP) does not endorse or imply endorsement of the resources provided here. These resources are provided without warranty of any kind, either expressed or implied. It is the responsibility of the user of the resource to judge its suitability for his or her particular purpose within the context of his or her practice and the applicable legislative framework. In no event shall CSHP or any persons involved in providing the resource be liable for damages arising from its use. Resources are free unless otherwise indicated. 

Keep in mind, some resources are not Canadian and may not be translated into Canadian practices.

The Canadian Guidelines for the Assessment and Diagnosis of Patients with Schizophrenia Spectrum and Other Psychotic Disorders gives an in-depth view of the schizophrenia spectrum. It dives into diagnosis and presents recommendations within this patient demographic. It used the ADAPTE1 process and takes into consideration of the National Institute for Health and Care Excellence (NICE) guidelines, the Scottish Intercollegiate Guidelines Network, the European Psychiatric Association, and the American Psychiatric Association in order to highlight the national interventions that can be implemented in Canadian practice. 

The Guidelines for the Pharmacotherapy of Schizophrenia in Adults outlines the recommendations based of the National Institute for Health and Care Excellence (NICE) guidelines, the Scottish Intercollegiate Guidelines Network, the European Psychiatric Association, and the American Psychiatric Association via the ADAPTEprocess. It elaborates on the selection of antipsychotics, acute treatment, antipsychotic continuation, antipsychotic dose/ trial duration, acute exacerbation, relapse prevention, and treatment-resistant schizophrenia given specific symptoms.

The Canadian Guidelines for the Pharmacological Treatment of Schizophrenia Spectrum and Other Psychotic Disorders in Children and Youth summarizes the main international and local guidelines focused on adolescents. Similar to the previous resources, it used the ADAPTEprocess and takes into consideration of the National Institute for Health and Care Excellence (NICE) guidelines, the Scottish Intercollegiate Guidelines Network, the European Psychiatric Association, and the American Psychiatric Association. It expresses the general principles of care, the first exposure of psychosis, and hospital care within the children and youth population.

The Clinical Handbook of Psychotropic Drugs is a textbook written by Ric M. Procyshyn et al. that highlights the psychotropic medications currently available. Published in 2019, it has a dedicated chapter on antipsychotics, where it elaborates on the pharmacology, dosing, switching medications, warnings, precautions, monitoring parameters and patient-related issues within this medication class. It goes into depth of explaining extrapyramidal symptoms caused by antipsychotics and their management. This textbook is also available online through a subscription here.

A Canadian website called SwitchRx is a practical tool used by healthcare professionals to guide clinical practice and adjust a patient’s psychotropic treatment regimens. This tool was developed by PsychedUp, a company where programs are certified by the College of Family Physicians of Canada. This tool develops tapering and titration schedules, clinical tips, and additional pharmacokinetic properties related to the medications. Keep in mind, you need to register for free and set up an account first before accessing their resources. It is a tool that allows switching between antipsychotics, and antidepressants and combining strategies between medications. It also has a tool that helps guide healthcare professionals in weight management and switching hypnotics. In addition, it gives access to psychiatric scales and treatment guidelines.

The Schizophrenia Society of Canada started as a non-profit, charitable organization in Toronto and now has grown in order to support research related to schizophrenia and early psychosis (biological, psychological, spiritual, and social determinants of health). They provide educational content for patients and provide support in cannabis and psychosis, family recovery journey, and have a podcast called Look Again: Mental Illness Re-examined to shine a light on the voices in the mental illness community.

Early Psychosis Intervention is an online tool that includes representatives from BC Health Authorities, the Ministry of Health, and family/caregivers to provide a resource for the community. It provides educational content that explains the definition of psychosis, the importance of early intervention, diagnosis and associated issues, what family members need to know, and the recovery process. It also has various informational pamphlets for patients that range from connecting to people, stress management to taking care of your health.

The Psychiatric Survivors of Ottawa is a non-profit member-driven platform located in Ottawa that offers Peer Support Programs. These include the Wellness Recovery Action Plan sessionspeer support groups, walking groups, and much more. They also cater to caretakers and incorporate Family Peer Support Programs which include Family Peer Support Group seminars, and Family Wellness Recovery Action Plan. They also have online workshops for non-local caretakers called Family Dialogue about Communication.

1 - ADAPTE process is a systematic approach to adapting guidelines from one cultural and organizational context to another. The overall aim of the process is to take existing guidelines and enhance them to ensure the final recommendations address specific health questions relevant to the context. Click here for more information on ADAPTE.




March 21, 2023
Resource spotlight: Schizophrenia

Latest News

CPRB News - March 2023 

March 21, 2023
Welcome, everybody, to the first post in our new series – CPRB News! 
This series will replace the Residency Board newsletter (RB News) and will feature monthly posts on a variety of residency-related topics.
This month, we will be focusing on CPRB-accredited programs, highlighting the programs we surveyed last season, as well as the programs we will be visiting in Spring 2023.
In Fall 2022, CPRB surveyors visited a total of six programs, including: Hamilton Health Sciences (Hamilton, ON), St. Joseph’s Healthcare (Hamilton, ON), Sunnybrook Health Sciences Centre – Year 1 General Program (Toronto, ON), Sunnybrook Health Sciences Centre – Year 1 Ambulatory Program (Toronto, ON), Women’s College Hospital (Toronto, ON), and Nova Scotia Health Authority (Halifax, NS). 
All programs were successful in securing renewed accreditation status. Congratulations to these programs on their achievements!
In Spring 2023, CPRB surveyors will be visiting another six programs, including: Interior Health (Kelowna, BC), Saskatchewan Health Authority (Saskatoon, SK), University of Waterloo / Centre for Family Medicine Family Health Team (Kitchener/Waterloo, ON), Island Health (Victoria, BC), Horizon Health Network (Moncton & St. John, NB), and Northern Health Authority (Prince George, BC).
We would like to thank the directors and coordinators of these programs for all the work they and their teams have devoted to preparing for the surveys. The Board appreciates your time, effort, and commitment to residency training, and we look forward to visiting you soon! 
Be sure to stay tuned for next month’s edition of CPRB News, where we will share some key statistics and upcoming changes to the Pharmacy Residency Application & Matching Service (PRAMS).
March 21, 2023
CPRB News - March 2023

Latest News

Together 2023: CSHP returns to Banff for a hybrid Together Conference 

March 20, 2023

By the numbers 

  • 811 Attendees
  • 47 Educational sessions delivered
  • 61 Posters presented
  • 33 Exhibitors
  • 26 Sponsors
  • 2,357 Game codes redeemed
  • 15+ CEUs available

Sessions and posters are still available for you in the virtual conference portal. It's not too late to register! Earn 15+ CEUs by watching on-demand or recorded sessions until March 27, 2022, 2:59 am ET.

Be sure to watch the eligible session in its entirety and fill out the session survey (pop-up or button) to have the session appear on your attendance certificate. You can find and print your attendance certificate by logging into the virtual portal your PheedLoop account as you did for the conference, selecting the Account tab in the left-hand panel of the main screen and clicking the Request New Certificate button. From there, you just need to print your certificate and add in your personal information to the declaration section. If you attended a session that was not credited on your CE certificate, please email with the specific session and date attended and we can credit your Pheedloop account with the missing session. 

Viewing satellite symposia 

Satellites were not accredited through CSHP, so please reach out to the sponsor directly for any satellite symposia inquiries. 

Missed out on the satellites or want to rewatch them? Check out the links below! 

Optimizing Hospitalized COPD Patients Post Exacerbation – Sponsored by GSK 

Every Dose Counts - Canada: The Value of IV Workflow Technology – Sponsored by Baxter 

Managing Patients on G-CSFs, Together – Sponsored by Pfizer 

Burden of Respiratory Syncytial Virus (RSV) Disease in Infants ‚ A Need for Universal Protection – Sponsored by Sanofi 

2023 Thrombosis Update: Cancer, COVID, and Clinical Guidelines – Sponsored by LEO Pharma 

Healthcare Supply Chain in the Spotlight - Lessons from the Past, Challenges in the Present, and the Outlook for the Future – Sponsored by Fresenius Kabi 


Together Conference 2023 wrap-up

 From March 10 to 12, speakers, poster presenters and attendees alike attended Together live in Banff or virtually across Canada. 

The weekend was full of inspiring keynote speeches from Dr. Paul Walker and Dr. Fiona Miller, to the moving keynotes from Will Flanary, also known as Dr. Glaucomflecken, Amanda Jetté Knox, and Blair Seifert, our 2023 Distinguished Service Award winner. 

Those attending this hybrid conference were lucky enough to enjoy the educational and the social parts of the conference. 

Our educational offerings included two pre-conference workshops, where attendees could learn how to use the Hospital Pharmacy in Canada Survey report or were able to take part in simulated toxicologic scenarios like overdoses. Other sessions ranged from the Harrison Plenary’s look at using data to making changes to hospital pharmacy practice on a local and national level, a Climate Change panel discussion that assessed the various ways we must do better to combat the climate emergency as healthcare professionals, in addition to the many concurrent, on-demand, and poster presentation sessions that provided attendees with plenty to learn. 

Meanwhile, the social aspects of Together 2023 were equally exciting. Totally rad ‘80s trivia, the return of CSHP conference favourites Dueling Piano Kings, the gala dinner where we also celebrated this year’s National Awards winners, and hospitality suites kept all involved entertained after three long years of minimal in-person interactions. This is not to forget the awesome prizes available to both in-person and virtual attendees, including Ultimate Dining Cards, RX Files 13th edition, Geri-RxFiles, complimentary registration for next year’s Professional Practice Conference, and an abundance of CSHP swag. 

With all this said and done, it’s officially a wrap on Together 2023. Thank you to everyone who made this weekend such a success. We’ll see you all at the 55th Professional Practice Conference in Niagara Falls next April! 



March 20, 2023
Together 2023: CSHP returns to Banff for a hybrid Together Conference

Clinical Pearls: Schizophrenia - An Overview

March 8, 2023
By Maria Ahmed

This article is part of a series appearing in Interactions, our biweekly newsletter, written and researched by CSHP's students. We've created this series as a valuable learning activity for pharmacy students undertaking rotations at CSHP. Crafting these pieces not only helps students gain in-depth knowledge of specific conditions, treatments, and resources, it also helps them hone their skills in research, critical appraisal, evaluation, synthesis, and writing – all of which will serve them well in clinical practice. The Professional Practice Team works with the students to select hot topics that are of interest and utility to both the students and to you, the reader. We hope you enjoy this piece by one of our future colleagues! Let us know what you think: If you would like to provide any comments or constructive feedback for our students, please email us at


Schizophrenia is a mental disorder that affects an individual’s interaction and understanding of the world.1 It is characterized by disruptions in thought processes, perceptions, emotional responsiveness, and social interactions.1 According to national data (2016-2017) of ages 10+, 147,500 Canadians used health services for schizophrenia, of which, 60% were men.The all-cause mortality rate in individuals who were diagnosed with schizophrenia was 2.8 times higher than those who are not.1,2  As with all mental disorders, schizophrenia is identified on the basis of clinical features. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) demonstrates a spectrum of symptomatic domains for psychosis and the manifestation of multiple diagnostic categories.3,4 Confirming a diagnosis can be difficult, but it is crucial to identify the most appropriate treatment modalities by taking a holistic approach.4 In terms of treatment, antipsychotic medications are highly effective for target symptoms, however, the prevention and management of adverse effects and drug interactions should be monitored carefully in an acute setting.5 In Canada, the adverse drug events (ADE) rate is 7.5 per 100 hospital admissions where 20.8% result in death.6 Pharmacists have been shown to improve treatment and economic outcomes and endorse a multidisciplinary care approach when administering antipsychotic medications and managing adverse events.5 Clinical pharmacists also assist with recommending dosage adjustments, assessing adherence, and administering standardized rating scales to monitor improvement.6 Before diving into treatment, it is important to understand the pathophysiology of schizophrenia and the symptoms that arise.6

Pathophysiology and Symptoms

Abnormalities and imbalances of neurotransmitters have provided the basic theories on the pathophysiology of schizophrenia.7 The neurotransmission theories incorporate either excess or deficiency of neurotransmitters, including dopamine, serotonin, and glutamate. Specifically, dopamine receptor sites (D2) are thought to be associated with the pathophysiology of schizophrenia.7 The four dopamine pathways are: (1) mesolimbic (2) mesocortical (3) nigrostriatal (4) tuberoinfundibular.7 These dopamine pathways help us understand the symptoms of schizophrenia and side effects caused by antipsychotic medications.5 There are two main heterogeneous characteristics of symptoms: positive and negative.7  Positive symptoms reflect an excess of normal function regulated by the mesolimbic dopamine pathway in the brain that can manifest in hallucinations, delusions, disorganized speech and behaviour, catatonic behaviour and thought disorder.7  Whereas negative symptoms reflect the absence of normal behaviours related to motivation and interest regulated by the mesocortical dopamine pathway in the brain.The current antipsychotic medications effectively manage positive symptoms, whereas, there are currently limited treatment options available for negative symptoms, indicating that there is an unmet medical need.7 

Treatment Options in the acute setting

Establishing patient-centered care and developing an alliance with the patient and the family is essential to formulate treatment plans and allow the patient to connect with their community.8-10 If involuntary hospitalizations are required when the patient poses a serious threat of harm to self or others, selecting the appropriate medication is routinely guided by the side effect profile and efficacy within the medication classes.8-10 Antipsychotic medications are generally the main cornerstone of schizophrenia management and initiation of treatment is vital within five years of an acute episode, as it is when most illness-related changes occur in the brain.8-10 Table 1 displays the medication classes, their main characteristics, and the monitoring parameters of antipsychotic medications. In an acute event displaying positive symptoms, the main goal of treatment is to decrease hostility and to allow the patient to return to normal functioning within seven days and with appropriate dosing and titration based on the patient’s response.8 Treatment during the acute phase is generally followed by a 12-month maintenance therapy where the main goal of treatment is to increase socialization, improve self-care and prevent relapses.8  It is important to avoid relapses, as one study demonstrated that over a 7-year follow-up, 80% of patients with schizophrenia had a significant correlation between the degree of deterioration and the number of relapses the patients experienced.11 In order to prevent relapse and re-hospitalization, maintenance therapy is required.6,12 One study showed the incidence of relapse among patients receiving maintenance therapy compared to those who have not received maintenance therapy was 18-32% versus 60-80%, respectively.6,12
The majority of guidelines recommend second-generation antipsychotic medications (SGA) – with the exception of clozapine - over first-generation antipsychotic medications (FGA) when treating a first-episode schizophrenia patient due to the side effect profile.13-16 Clozapine is reserved for refractory psychosis due to the risk of agranulocytosis and its’ weak affinity to D2 receptors.13-17 If the initial acute treatment of antipsychotic is not effective or tolerated after an adequate trial of an appropriate dose antipsychotic, switching to a different monotherapy treatment is recommended. The ultimate choice of selecting an antipsychotic should consider patient factors and preferences, the risk of metabolic effects, the trajectory of response, and the patient’s symptom patterns.13-17 If there is no response to the optimized medication regimen after 2-4 weeks, a change of the medication can be considered by a cross-taper method (minimizes withdrawal-emergent effects) or a delayed withdrawal method (preferred when relapse is a concern).19 If there is a partial response, the response to treatment can be assessed after an adequate trial of ≥ 4-6 weeks at ≥50% of the dose and can typically require at least 20% of improvement in symptoms via the reduction in Positive and Negative Syndrome Scale (PANSS) or Brief Psychiatric Rating Scale (BPRS), to name a few.13-17
There is advocacy to use long-acting injections earlier in course of treatment and should not only be considered for non-adherence concerns.19-21  In a 2015 RCT, Subotinik et al compared the clinical efficacy of the long-acting injection (LAI) and oral formulation of risperidone within the first episode of schizophrenia.21 The results demonstrated a statistically significant lower rate of psychotic exacerbation and/or relapse in the LAI of risperidone compared to oral formulation (RRR 84.7%).21 In a systematic review and analysis of mirror-image studies, Kishimoto et al demonstrated that LAIs showed a strong superiority compared to oral antipsychotic medications in preventing hospitalization.27 It is important to stay vigilant and counsel patients with LAI treatment, as LAI can induce extrapyramidal symptoms (EPS).22
Management of Extrapyramidal Symptoms   
From dopamine-receptor blocking agents, extrapyramidal symptoms (EPS) are one of the most common adverse drug effects patients experience).28,29 They can manifest within 24-48 hours of treatment and if not treated appropriately, can have detrimental effects on the patient long term such as bone deformities or significant motor impairment, or potentially lead to death.28,29 A variety of movement phenotypes have been described along the EPS spectrum, including dystonia, akathisia and parkinsonism.28,29 Pharmacists play a key role in managing the adverse effects of EPS and handling polypharmacy within this patient demographic.30 Often when managing adverse effects, rather than changing the medication or the dose of the offending medication, physicians tend to add a new medication to counteract the adverse effect.30  It is important to note the drug-induced EPS and manage it appropriately by first targeting the offending agent itself.30 
Acute Pseudo-Parkinsonism23 
With a prevalence of approximately 20%, it can manifest in tremors (“pill-rolling” type), rigidity (cogwheel) or bradykinesia (mask-like expression, shuffling gait, slowness of movement) where 90% occur within the first 6 weeks of treatment and does not stop throughout the clinical course of the treatment. Other psychological symptoms include slow thinking, fatigue, and cognitive impairment where the most at-risk populations include elderly females, high potency of FGA, HIV infection, family history of Parkinson’s disease, those with pre-existing neurological damage (e.g. stroke), discontinuing anticholinergics, and adding a second antipsychotic. The treatment includes either decreasing the dose of the antipsychotic, changing the antipsychotic or supplementing with anticholinergics. 
Acute Dystonia and Akathisia19
Acute dystonia is torsions and spasms of the muscle located around the head and neck whereas acute akathisia is motor restlessness, fidgeting, pacing, rocking, swinging and intense urge to move. Acute dystonia can occur within 24-48 hours after the first dose and 90% occur within the first week of treatment and 90% of acute akathisia episodes can occur within the first 6 weeks of treatment, mainly with higher doses. Both acute states include a high-risk patient demographic that has a high potency of FGA. If not treated, acute dystonia can result in acute laryngeal/pharyngeal dystonia that can be life-threatening and acute akathisia can increase risk of tardive dyskinesia and can contribute to suicide and violence. One main difference in treatment is that acute dystonia can be treated by antiparkinsonian drugs, whereas in acute akathisia, antiparkinsonian drugs are not very effective. Both can also be treated by reducing the dose, changing the antipsychotic or adding lorazepam. 
Tardive Dyskinesia vs Dystonia vs Akathisia19
Tardive dyskinesia is the involuntary movements that are abnormal to the face (ticks, frowning), lips (pursing, smacking), jaw (chewing, clenching), tongue (rolling), eyelids (blinking), limbs (tapping), trunk (rocking), and neck (nodding). The onset is after 3 or more months of therapy. These symptoms can disappear during sleep and the most at-risk populations include those aged over 40, female, history of EPS, chronic use of FGA, cognitive impairment, alcohol or drug abuse or organic brain damage. Whereas tardive dystonia is the sustained muscle contractions the of face, jaw, tongue, eyes, neck, links, back or trunk. It can occur after months/years of therapy in high-risk populations, which include young males, coexisting tardive dyskinesia, akathisia or mental retardation. Treatment options include switching to a different SGA or third-generation antipsychotic (TGA) or adding an anticholinergic. Tardive akathisia treatments also include adding beta-blockers such as propranolol. However, discontinuing the antipsychotic early can increase the chance of remission in all three states.
Table 1: Characteristics of first, second, and third generation of antipsychotic medications  to treat schizophrenia23

Pharmacist’s Role

It is important to note that schizophrenia can lead to negative health outcomes and early death as well as economic loss at a national and global scale.24-26 Without proper medication management, the risk of drug therapy problems increases the risk of hospitalization, morbidity, mortality, and healthcare expenditure Patients with schizophrenia are often treated with several medications for severe diseases and this opens the risk of polypharmacy and irrational combinations of medications.24-26 Pharmacists provide a promising approach to improve medication adherence and establish a collaborative approach in primary care settings.24-26 A systematic review of the impact of clinical pharmacists’ interventions in patients demonstrated multiple positive outcomes of various services within the psychiatric setting24. A few positive outcomes included improved adherence to antipsychotic treatment guidelines, decreased drug-related problems, decreased drug-drug interactions, improvement in patient quality of life, and cost-saving interventions were implemented.24-26 A scoping review of a clinical pharmacist in a mental health hospital setting demonstrated that the incorporation of clinical pharmacists improves medication management by providing guidance, identifying gaps in complex health needs, establishing evidence-based studies, facilitating the transition of care through medication reconciliation and follow-up, and reducing overall hospital admissions.24 Pharmacists have shown they are vital to team-based collaboration for patient-centered care to successfully improve patient quality of life.24-26


  1. U.S. Department of Health and Human Services. (n.d.). Schizophrenia. National Institute of Mental Health. Retrieved November 3, 2022, from 
  2. Canada, P. H. A. of. (2020, July 6). Government of Canada. Retrieved November 3, 2022, from 
  3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fifth edition. Arlington (VA): American Psychiatric Association; 2013.
  4. Abidi S, Mian I, Garcia-Ortega I, et al. Canadian Guidelines for the Pharmacological Treatment of Schizophrenia Spectrum and Other Psychotic Disorders in Children and Youth. The Canadian Journal of Psychiatry. 2017;62(9):635-647. doi:10.1177/0706743717720197
  5. Goldstone, L. W., DiPaula, B. A., Werremeyer, A., Botts, S., Hepburn, B., Liu, H. Y., Duckworth, K., Young, A. S., & Kelly, D. L. (2021). The role of board-certified psychiatric pharmacists in expanding access to care and improving patient outcomes. Psychiatric Service.2021;72(7):794–801. 
  6. Baker GR, Norton PG, Flintoft V, Blais R, Brown A, Cox J, Etchells E, Ghali WA, Hébert P, Majumdar SR, O'Beirne M, Palacios-Derflingher L, Reid RJ, Sheps S, Tamblyn R. The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada. CMAJ. 2004 May 25;170(11):1678-86. doi: 10.1503/cmaj.1040498. PMID: 15159366; PMCID: PMC408508.
  7. Correll CU, Schooler NR. Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment. Neuropsychiatr Dis Treat. 2020 Feb 21;16:519-534. doi: s10.2147/NDT.S225643. PMID: 32110026; PMCID: PMC7041437
  8. Patel KR, Cherian J, Gohil K, Atkinson D. Schizophrenia: overview and treatment options. P T. 2014 Sep;39(9):638-45. PMID: 25210417; PMCID: PMC4159061.
  9. Lehman AF, Lieberman JA, Dixon LB, et al. American Psychiatric Association Practice Guidelines; Work Group on Schizophrenia. Practice guideline for the treatment of patients with schizophrenia. Am J Psychiatry. (2nd ed) 2004;161(suppl 2):1–56.
  10. Castle DJ, Buckley PF. Schizophrenia. Oxford, United Kingdom: Oxford University Press; 2008.
  11. Curson DA, Barnes TR, Bamber RW, Platt SD, Hirsch SR, Duffy JC. Long-term depot maintenance of chronic schizophrenic out-patients: the seven year follow-up of the Medical Research Council fluphenazine/placebo trial. III. Relapse postponement or relapse prevention? The implications for long-term outcome. Br J Psychiatry. 1985;146:474–480. doi: 10.1192/bjp.146.5.474.
  12. Leucht S, Barnes TR, Kissling W, et al. Relapse prevention in schizophrenia with new-generation antipsychotics: a systematic review and exploratory meta-analysis of randomized controlled trials. Am J Psychiatry. 2003;160(7):1209–1222.
  13. Correll, C.U., Martin, A., Patel, C. et al. Systematic literature review of schizophrenia clinical practice guidelines on acute and maintenance management with antipsychotics. Schizophr 8, 5 (2022).
  14. Galletly, C. et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders. Aust. N. Z. J. Psychiatry 50, 410–472 (2016).
  15. Texas Medication Algorithm Project (TMAP). Texas Medication Algorithm Project (TMAP) Procedural Manual. (2008). Available at:
  16. Mental Health Clinical Advisory Group, Oregon Health Authority. Mental Health Care Guide for Licensed Practitioners and Mental Health Professionals. (2019). Available at:
  17. Crismon L, Argo TR, Buckley PF. Schizophrenia. In: DiPiro JT, Talbert RL, Yee GC, et al., editors. 1Pharmacotherapy: A Pathophysiologic Approach. 9th ed. New York, New York: McGraw-Hill; 2014. pp. 1019–1046. 
  18. Srifuengfung M, Sukakul T, Liangcheep C, Viravan N. Paliperidone palmitate-induced facial angioedema: A case report. World J Clin Cases. 2020;8(20):4876-4882. doi:10.12998/wjcc.v8.i20.4876
  19. Remington G, Addington D, Honer W, Ismail Z, Raedler T, Teehan M. Guidelines for the Pharmacotherapy of Schizophrenia in Adults. The Canadian Journal of Psychiatry. 2017;62(9):604-616. doi:10.1177/0706743717720448.
  20. Malla A, Tibbo P, Chue P, et al. Long-acting injectable antipsychotics: recommendations for clinicians. Can J Psychiatry. 2013;58(5 Suppl 1):30S-35S.
  21. Subotnik KL, Casaus LR, Ventura J, et al. Long-acting injectable risperidone for relapse prevention and control of breakthrough symptoms after a recent first episode of schizophrenia: a randomized clinical trial. JAMA Psychiatry. 2015;72(8): 822-829.
  22. Kim DD, Lang DJ, Warburton DER, Barr AM, White RF, Honer WG, Procyshyn RM. Exercise and Worsening of Extrapyramidal Symptoms during Treatment with Long-Acting Injectable Antipsychotics. Pharmacy (Basel). 2021 Jul 3;9(3):123. doi: 10.3390/pharmacy9030123. PMID: 34287361; PMCID: PMC8293348.
  23. Procyshyn, R., Bezchlibnyk-Butler, K. Z., & Jeffries, J. J. (2021). Clinical Handbook of Psychotropic Drugs. Hogrefe Publishing. 
  24. Javedh S, Padma R, Sridhar BS, Shariff A, et al. A Systematic Review on the Impact of Clinical Pharmacist Interventions in Patients with Mental Health Disorders.Clin Schizorph Relat Psychoses. 2020;14:3.
  25. Ambed Mishra, G Sai Krishna, A. Sravani, Tony D. Kurian, Justin Kurian, M. Ramesh, M. Kishor. Impact of pharmacist-led collaborative patient education on medication adherence and quality of life of schizophrenia patients in a tertiary care setting, Bulletin of Faculty of Pharmacy, Cairo University, 2017;55(2):345-349.
  26. Mechaiel Farag, Leanne Chalmers, Kreshnik Hoti, Jeff Hughes. The role of the clinical pharmacist in mental health hospital-in-the-home: A scoping review. Research in Social and Administrative Pharmacy. 2022;18(10):3724-3735. 
  27. Kishimoto T, Nitta M, Borenstein M, Kane JM, Correll CU. Long-acting injectable versus oral antipsychotics in schizophrenia: a systematic review and meta-analysis of mirror-image studies. J Clin Psychiatry. 2013 Oct;74(10):957-65. doi: 10.4088/JCP.13r08440. PMID: 24229745.
  28. Tamara Pringsheim, MD MSc, Asif Doja, MD MEd, Stacey Belanger, MD PhD, Scott Patten, MD PhD, The Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children (CAMESA) guideline group, Treatment recommendations for extrapyramidal side effects associated with second-generation antipsychotic use in children and youth, Paediatrics & Child Health, Volume 16, Issue 9, November 2011, Pages 590–598,
  29. D'Souza RS, Hooten WM. Extrapyramidal Symptoms. [Updated 2022 Aug 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:
  30. Hashimoto Y, Tensho M. Effect of pharmacist intervention on physician prescribing in patients with chronic schizophrenia: a descriptive pre/post study. BMC Health Serv Res. 2016 Apr 26;16:150. doi: 10.1186/s12913-016-1408-4. PMID: 27117589; PMCID: PMC4847190.



Latest News

March 08, 2023
Clinical Pearls: Schizophrenia - An Overview

Latest News

Together 2023: Get to know our keynote speakers!

February 28, 2023
This year, Together: Canada’s Largest Hospital Pharmacy Conference is lucky to be bringing four incredible keynote speakers to Together attendees both live in Banff and virtually from coast-to-coast!
Hear these leaders in pharmacy, medicine and social betterment by registering today.

Dr. Paul Walker

International Keynote - Making a Difference Together / March 10, 2023
Paul C. Walker, PharmD, FASHP, FMPA is Clinical Professor and Assistant Dean of Experiential Education and Community Engagement, College of Pharmacy, and Manager, Department of Pharmacy, Michigan Medicine, at the University of Michigan. He previously served in clinical practice and pharmacy leadership roles at the Detroit Medical Center, the Lafayette Clinic, and Henry Ford Health System, and held faculty appointments at Wayne State University. Walker received his BS in Pharmacy and PharmD from Wayne State University. He completed an ASHP‐ accredited residency at Children’s Hospital of Michigan and specialty residency in pediatric pharmacy practice at the University of Tennessee and LeBonheur Children’s Medical Center, Memphis, TN. He served a three‐year term on the American Society of Health‐System Pharmacists (ASHP) Board of Directors and was recently elected as President‐elect of the organization. His ASHP service includes Chair, Committee on Nominations; Commission on Affiliate Relations; ASHP Foundation Donor Retention Subcommittee; and Michigan Delegate to the House of Delegates. He recently served as Chair of and Board Liaison to the ASHP Task Force on Racial Diversity, Equity, and Inclusion. Walker has served in leadership positions in the Michigan Pharmacists Association (MPA), and Michigan Society of Health‐System Pharmacists (MSHP). He received several awards from MSHP, including the 2008 MSHP Professional Practice Award, the 2010 MSHP Pharmacist of the Year Award, the 2017 MSHP Joseph A. Odis Leadership Award, and the 2022 MPA Pharmacist of the Year Award. He has been inducted into the MPA Hall of Honor and is recognized as a Fellow of both ASHP and MPA. His interests include pharmacy practice model development; assessment of the impact of pharmacists on patient outcomes; transitions of care; pediatric pharmacotherapy; experiential education and interprofessional education. He has authored numerous peer‐reviewed articles and book chapters, with publications appearing in American Journal of Health System Pharmacy, American Journal of Pharmaceutical Education, and Archives of Internal Medicine, Currents in Pharmacy Teaching and Learning and other journals. He is passionate about advancing pharmacy practice by innovating pharmacist services, evaluating pharmacists’ impact on patient care, and especially by integrating student pharmacists into practice models and interprofessional teams through work in experiential education.

Learn more about his keynote, sponsored by Sandoz,  here

Will Flanary (Dr. Glaucomflecken)

Celebrity Keynote - Wife or Death / March 11, 2023
Will Flanary is an ophthalmologist and part time comedian who moonlights in his free time as “Dr. Glaucomflecken,” a social media personality who creates medical-themed comedy shorts to an audience of over 3 million across social media. His humor has been shaped by the tribulations of med school and residency, but also by his experiences as a patient. Will is a 2-time testicular cancer survivor as well as a survivor of cardiac arrest, saved by his intrepid wife and her timely CPR. Initially used as a creative outlet to cope with these health challenges, Will’s comedy has evolved over time to incorporate biting satire of the US health care system, academic publishing, and interpersonal conflicts pervasive in the medical system. He is a frequent keynote speaker who encourages medical audiences to embrace humor in every day life.

Learn more about his keynote, sponsored by Apotex, here

Dr. Fiona Miller

Insight Keynote - Towards a Sustainable Healthcare System: A Call to Action for Pharmacy Professionals / March 11, 2023
Dr. Fiona Miller is a professor of Health Policy & Chair in Health Management Strategies & Founder and Director of the Centre of Sustainable Health Systems atthe University of Toronto - Dalla Lana School of Public Health. Her research focuses on improving environmental and social sustainability of health systems via research, practice change, and policy development. As a policy scholar, she brings a political sociology perspective to analyzing technological innovation and sustainability transitions. Fiona is a leader in developing educational and research initiatives in collaboration with health sector partners to build sustainable health systems.
Learn more about her keynote, sponsored by HealthPRO, here

Amanda Jetté Knox

Grand Finale Keynote - Care and Compassion: Helping Transgender People Thrive in Healthcare and Beyond / March 12, 2023
Amanda Jetté Knox (they/them) is a National Bestselling Author, Award-winning Writer, Human Rights Advocate, and sought-after keynote speaker.  Amanda is the author of Love Lives Here: A Story of Thriving in a Transgender Family, a Globe and Mail and Toronto Star bestseller. On the speaking platform, they share their family’s story about the power of acceptance, understanding, vulnerability and unconditional love, in the hopes of normalizing the existence of 2SLGBTQ+ families. As a mental health advocate, Amanda also brings to life the necessity of facing mental illness without stigma. Having confronted a series of personal challenges and a major mental health crisis, which required hospital treatment and weeks of intense trauma therapy, Amanda is no stranger to cultivating resilience during times of major upheaval. Several national and international media outlets, including CBC, CTV’s The Social, The Marilyn Denis Show, Chatelaine, O Magazine and Upworthy, have featured Amanda’s work. Amanda has shared their message all over the country, from working with the UN Human Rights Campaign in Montreal, Quebec, to addressing corporate, university/college students, educators, and government audiences. Amanda is honoured and humbled to be a recipient of the 2021 Order of Ottawa for their advocacy of transgender, gender-creative, and non-binary youth and their work helping others with mental health issues.
Learn more about their keynote, sponsored by Fresenius Kabi, here


February 28, 2023
Together 2023: Get to know our keynote speakers

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The Value of Hospital Pharmacists

Every day, hospital pharmacy teams improve your health and save our hospitals money. They are trusted and valued members of the healthcare team.

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