Mental health

Antipsychotic medications for psychotic disorders

Question 1: In individuals with psychotic disorders (including schizophrenia), are antipsychotic drugs safe and effective?

Management of psychosis and bipolar disorders

  • Population: adults with psychotic disorders (including schizophrenia)
  • Interventions: antipsychotics drugs
  • Comparison: placebo
  • Outcomes:
    • symptoms severity
    • prevention of relapses
    • disability and functioning
    • quality of life
    • adverse effects of treatment
    • mortality
    • treatment adherence
    • users' and families' satisfaction with care.

Recommendation(s)

Haloperidol or chlorpromazine should be routinely offered to individuals with psychotic disorders (including schizophrenia).
Strength of recommendation: STRONG

Second-generation antipsychotics (with the exception of clozapine) may be considered in individuals with psychotic disorders (including schizophrenia) as an alternative to haloperidol or chlorpromazine if availability can be assured and cost is not a constraint.
Strength of recommendation: STANDARD

For individuals with psychotic disorders (including schizophrenia) who do not respond to adequate dose and duration of other antipsychotic medicines, clozapine may be considered by non-specialist health care providers, preferably under the supervision of mental health professionals, only if routine laboratory monitoring is available.
Strength of recommendation: STANDARD

In individuals with psychotic disorders (including schizophrenia), minimal effective dose of antipsychotics should be used, paying attention to minimizing adverse effects.
Strength of recommendation: STRONG

In women with psychotic disorders (including schizophrenia) who are planning a pregnancy or pregnant or breastfeeding, low-dose oral haloperidol or chlorpromazine may be considered.
Strength of recommendation: STANDARD

Evidence profile

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