Diagnosis and Management Considerations in Acute and Maintenance Treatment of Schizophrenia

Dr. Harvey is Professor of Psychiatry, Mount Sinai School of Medicine

Dr. Buckley is Professor and Chair of Psychiatry, Medical College of Georgia

Accreditation Statement

This activity has been planned and implemented in accordance with the Essentials and Standards of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Mount Sinai School of Medicine and MBL Communications, Inc. The Mount Sinai School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation

The Mount Sinai School of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Faculty Disclosure Policy Statement

It is the policy of the Mount Sinai School of Medicine to ensure objectivity, balance, independence, transparency, and scientific rigor in all CME-sponsored educational activities. All faculty participating in the planning or implementation of a sponsored activity are expected to disclose to the audience any relevant financial relationships and to assist in resolving any conflict of interest that may arise from the relationship. Presenters must also make a meaningful disclosure to the audience of their discussions of unlabeled or unapproved drugs or devices.

This activity has been peer reviewed and approved by Eric Hollander, MD, chair at Mount Sinai School of Medicine. Review Date: September 5, 2006.

Statement of Need

Schizophrenia is among the world’s top 10 causes of long-term disability, affecting ~1% of the United States population, with similar rates across countries, cultural groups, and genders. The course of illness is generally chronic with acute psychotic exacerbations that may require frequent hospitalization. Predictors of frequent relapse include poor compliance with antipsychotic drug treatment, severe residual psychopathology, comorbid substance abuse, and poor relationships between patients, families, and care providers.

Newer atypical antipsychotics have become the treatment of choice for schizophrenia. Maintenance treatment with antipsychotics can dramatically reduce the rate of relapse for patients with schizophrenia. Factors contributing to the rate of noncompliance include medication side effects, severity of psychotic symptoms, impaired cognition, and inadequate understanding of the role of medication for preventing relapse.

An important educational need exists to refine the diagnostic and treatment strategies of physicians in order to increase compliance and remission rates in patients with early psychosis. Clinicians need to accurately diagnose patients in the first episode and be aware of the newest agents and treatment options to optimize outcome and response.

Learning Objectives

• Describe the importance of early and accurate diagnosis of patients with schizophrenia in the acute care setting to limit rehospitalization.
• Assess the latest treatment information on the acute care and maintenance treatment of schizophrenia.
• Explain the newest treatment strategies to enhance safety and compliance.

Target Audience

This activity will benefit psychiatrists, hospital staff physicians, and office-based “attending” physicians from the community.

Funding/Support

This activity is supported by an unrestricted educational grant from Janssen, L.P.

Faculty Disclosures

Dr. Harvey is a consultant to Abbott, AstraZeneca, Janssen, Memory, Merck, Pfizer, and sanofi-aventis; is on the advisory boards of Eli Lilly and Forest; and receives grant support from Bristol-Myers Squibb.

Dr. Buckley is a consultant to Abbott, Alamo, AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Janssen, Merck, and Pfizer; receives grant/research support from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Janssen, National Institute of Mental Health, Pfizer, and Solvay; and receives honoraria/expenses from Abbott, Alamo, AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Janssen, and Pfizer.

Peer Reviewers

Eric Hollander, MD, reports no affiliation with or financial interest in any organization that may pose a conflict of interest.

David L. Ginsberg, MD, is on the speaker’s bureaus of and receives honoraria from AstraZeneca and Bristol-Myers Squibb.

To Receive Credit for this Activity

Read this article, reflect on the information presented, and then complete the CME quiz found here: www.mssmtv.org/psychweekly. To obtain credit you should score 70% or better. The estimated time to complete this activity is 1 hour.

Release Date: October 1, 2006

Termination Date: October 1, 2008

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