Guidelines for antipsychotic drug treatment of schizophrenia.

Rationale: The SiGMA algorithm and corresponding guidelines for the antipsychotic treatment of schizophrenia and related disorders were developed out of the finding that across the twelve provider units of Greater Manchester, the use of, and expenditure on, clozapine and the other new atypical antipsychotic drugs varied greatly. There were no locally agreed standards or guidelines in place for the prescription of such drugs. Individual Trusts varied in whether they had current guidelines for the prescription of antipsychotic medication, the content of such guidelines, and the extent to which the guidelines were being followed by clinicians.The SiGMA guidelines have been adapted by the Manchester Mental Health and Social Care Trust Medicines Management Committee taking into account the NICE Guidelines ?Guidance on the use of newer (atypical) antipsychotic drugs for the treatment of schizophrenia?.Scope: The guidelines and accompanying algorithm offer a first-line choice of atypical or conventional antipsychotic treatment to be made in consultation with the patient, although the preferred treatment of choice would be an atypical antipsychotic. The algorithm avoids unnecessary delays in proceeding to clozapine, if appropriate and recognises evidence for psychological therapies in improving the outcome for patients with schizophrenia.Patient group: Primarily patients aged between 16-64 years with schizophrenia or related functional disorders. For patients with these conditions who are elderly, lower doses than in younger adults should be considered and particular attention paid to side-effects.