Experts develop new guidelines for the treatment of schizophrenia

New guidelines have been developed for the treatment of schizophrenia after a collaboration of international experts from 30 countries.

University of Queensland Professor of Psychiatry Dan Siskind said the International Guidelines for Algorithmic Treatment (INTEGRATE) offer a 'globally relevant' approach to treating the mental illness.

Schizophrenia imposes a significant healthcare burden worldwide with substantial physical health comorbidities.

The new guidelines include shared patient-doctor decision making, and tailored individual treatment, making it more likely people stick with treatment.

They offer hope and will improve the quality of life for patients and their families.''

Dan Siskind, Professor of Psychiatry, University of Queensland 

Professor Siskind answers some key questions:

How will the new guidelines make a difference to people living with schizophrenia?

"The INTEGRATE guidelines offer a practical, step-by-step approach to choosing and managing medications for people with schizophrenia," Professor Siskind said.

"Unlike older guidelines that were often too long or focused only on specific countries, these are designed to be used anywhere in the world.

"They help doctors and people with schizophrenia act faster when treatment isn't working, focus on each person's symptoms, and manage side effects early.

"This means people can get the right treatment sooner, feel better faster, and reduce the risk of serious physical health problems that often go along with schizophrenia."

What are the harmful side effects associated with medications to treat schizophrenia?

"Medications for schizophrenia, especially antipsychotics, can cause a range of side effects," Professor Siskind said.

"These may include weight gain, diabetes, high cholesterol, movement problems like tremors or restlessness, hormonal changes such as raised prolactin, and sleepiness.

"Some side effects can increase the risk of serious health issues like heart disease or diabetes, so regular monitoring and early management are very important."

Do these side effects have a significant impact on whether people continue to take their medications?

"Side effects are one of the main reasons people stop taking their medication," Professor Siskind said.

"If someone feels worse on the medication or gains a lot of weight quickly, they may choose to stop taking it, even if it's helping their mental health symptoms.

"That's why these guidelines stress shared decision-making and early action to manage side effects – so people are more likely to choose to stick with treatment."

Are there new treatments to potentially improve the lives of people with schizophrenia?

"There are promising new treatments on the horizon," Professor Siskind.

"GLP-1 receptor agonists for example, a type of medication also used for diabetes and weight loss, may help manage weight gain caused by antipsychotics.

"A new medicine called xanomeline-trospium has also been approved and works differently from traditional antipsychotics, which could offer benefits for people who haven't responded well to existing medications.

"Researchers are also working on tools to predict which treatments might work best for each individual."

What is your message to those living with schizophrenia and the medical community with the release of these guidelines?

"These new guidelines offer hope,'' Professor Siskind said.

"They show that treatment can be tailored to the individual, with careful attention to both mental and physical health.

"For people living with schizophrenia and their families, it's a reminder that their voice matters in treatment decisions.

"For doctors, it's a call to act early, listen closely, and work together with patients. Better treatment is not just about controlling symptoms-it's about improving quality of life."

The INTEGRATE guidelines were produced in collaboration with researchers across multiple institutions, including the University of Oxford.

The research is published in The Lancet Psychiatry.