Webinar “New Horizons in the Treatment of Schizophrenia” with the Support of Darnitsa Pharmaceutical Company28 April 2021
On April 20, 1,162 psychiatrists, neurologists, psychologists and psychotherapists took part in the webinar “New Horizons in the Treatment of Schizophrenia”, which was held with the support of Darnitsa Pharmaceutical Company. During the event, the issues of personalized approaches in the treatment of schizophrenia, the importance of the patient’s personality in the successful management of the disease and new opportunities in patient management, the emergence of which is predicted in the near future, were considered.
The keynote speaker was Christoph U. Correll, Professor of Psychiatry and Molecular Medicine at the Donald and Barbara Zucker School of Medicine in Hofstra/Northwell (New York, USA), Professor of Child and Adolescent Psychiatry at Charité Medical School, Germany. Professor Correll is the author and co-author of more than 650 articles published in the most respected scientific journals. For seven years he has been included in the prestigious ranking of scientists Clarivate / Web of Science as one of the most influential and cited specialists in the world psychiatry.
In his presentation, Professor Correll spoke about the evolution of goals and challenges of treating patients with schizophrenia, acute period treatment, maintenance treatment and new drugs, and gave practical advice to Ukrainian colleagues on reducing the side effects of antipsychotics, increasing adherence to treatment, improving the quality of life and resocialization of patients.
Evolution of Views in the Treatment of Schizophrenia
Professor Correll drew attention to significant changes that occurred in approaches to the treatment of schizophrenia. In addition to overcoming positive symptoms as such, improvement of the functionality and quality of life, prolonging the remission period have also become the purpose of the treatment. Much attention is now paid to negative symptoms, too, – asociality, decreased motivation, alogy, the burden of which significantly exceeds the burden of symptoms of the acute period and affects the social integration of the patient, as well as cognitive manifestations of schizophrenia.
According to him, a necessary prerequisite for successful treatment is an early start. The requirements for drugs have become more stringent: they must have a good tolerability profile, must not affect motor symptoms or cause secondary cognitive dysfunction.
In addition, it is important to keep in mind that people with schizophrenia get depressed and suicidal, especially in the first 2-5 years when they become aware of their illness: depression lowers the quality of life more than residual positive or negative symptoms. Therefore, the key to the general treatment of schizophrenia is an antipsychotic, which also has an antidepressant effect. There are currently 5 antipsychotics approved for monopolar and bipolar depression: quetiapine, aripiprazole, brexpiprazole, cariprazine, and lurasidone.
Second-generation antipsychotics, which do not excessively block dopamine, allow therapy to focus on not exacerbating negative symptoms and reducing side effects. Now doctors have drugs that are safer in cardiometabolic terms that should be used at the beginning of treatment, prescribing them to those who respond to such therapy, and only then switch to drugs with more side effects.
Important findings from Psychiatry Professor Christoph U. Correll
- Schizophrenia remains a severe and often chronic disease which is a major burden. But the findings show that early intervention, shorter duration of psychosis before and after treatment are associated with better outcomes for patients.
- Comprehensive treatment is better than conventional treatment.
- The correct start of the therapy affects the further course of the disease, and therefore is extremely important.
- Maintenance antipsychotic treatment is a key.
- Efficiency and tolerability should be as balanced as possible.
- Resistance to treatment should be prevented, identified and treated on the basis of scientific evidence.
- Future-oriented – the treatment based on patient assessment, personalized medicine and the latest mechanisms of action should improve overall outcomes.
The webinar was moderated by Oleh Chaban, MD, Professor, Head of the Department of Medical Psychology, Psychosomatic Medicine and Psychotherapy of the Bogomolets National Medical University. Professor Chaban also presented a vision of the changes taking place in psychiatry in the postmodernism period to the participants of the webinar.