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 practice@cshp.ca

Bacground

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.