On the road to individualizing pharmacotherapy for adolescents and adults with schizophrenia - results from an expert consensus following the Delphi method

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• dc.contributor.author Guinart, Dani
• dc.contributor.author Fagiolini, Andrea
• dc.contributor.author Fusar-Poli, Paolo
• dc.contributor.author Giordano, Giulia Maria
• dc.contributor.author Leucht, Stefan
• dc.contributor.author Moreno, Carmen
• dc.contributor.author Correll, Christoph U.
• dc.date.accessioned 2025-07-10T06:12:01Z
• dc.date.available 2025-07-10T06:12:01Z
• dc.date.issued 2024
• dc.description.abstract Introduction: Schizophrenia is a severe mental illness that usually begins in late adolescence or early adulthood. Current pharmacological treatments, while acceptably effective for many patients, are rarely clinically tailored or individualized. The lack of sufficient etiopathological knowledge of the disease, together with overall comparable effect sizes for efficacy between available antipsychotics and the absence of clinically actionable biomarkers, has hindered the advance of individualized medicine in the treatment of schizophrenia. Nevertheless, some degree of stratification based on clinical markers could guide treatment choices and help clinicians move toward individualized psychiatry. To this end, a panel of experts met to formally discuss the current approach to individualized treatment in schizophrenia and to define how treatment individualization could help improve clinical outcomes. Methods: A task force of seven experts iteratively developed, evaluated, and refined questionnaire items, which were then evaluated using the Delphi method. Descriptive statistics were used to summarize and rank expert responses. Expert discussion, informed by the results of a scoping review on personalizing the pharmacologic treatment of adults and adolescents with schizophrenia, ultimately generated recommendations to guide individualized pharmacologic treatment in this population. Results: There was substantial agreement among the expert group members, resulting in the following recommendations: 1) individualization of treatment requires consideration of the patient's diagnosis, clinical presentation, comorbidities, previous treatment response, drug tolerability, adherence patterns, and social factors; 2) patient preferences should be considered in a shared decision-making approach; 3) identified barriers to personalized care that need to be overcome include the lack of actionable biomarkers and mechanistic similarities between available treatments, but digital tools should be increasingly used to enhance individualized treatment. Conclusion: Individualized care can help provide effective, tailored treatments based on an individual's clinical characteristics, disease trajectory, family and social environment, and goals and preferences.
• dc.format.mimetype application/pdf
• dc.identifier.citation Guinart D, Fagiolini A, Fusar-Poli P, Giordano GM, Leucht S, Moreno C, et al. On the road to individualizing pharmacotherapy for adolescents and adults with schizophrenia - results from an expert consensus following the Delphi method. Neuropsychiatr Dis Treat. 2024 May 24;20:1139-52. DOI: 10.2147/NDT.S456163
• dc.identifier.doi http://dx.doi.org/10.2147/NDT.S456163
• dc.identifier.issn 1176-6328
• dc.identifier.uri http://hdl.handle.net/10230/70876
• dc.language.iso eng
• dc.publisher Dove Medical Press
• dc.relation.ispartof Neuropsychiatr Dis Treat. 2024 May 24;20:1139-52
• dc.rights © 2024 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, 3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc/3.0/
• dc.subject.keyword Personalized
• dc.subject.keyword Psychiatry
• dc.subject.keyword Psychopharmacology
• dc.subject.keyword Psychosis
• dc.subject.keyword Treatment
• dc.title On the road to individualizing pharmacotherapy for adolescents and adults with schizophrenia - results from an expert consensus following the Delphi method
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion