| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Pharmacological treatment of schizophrenia: Japanese Expert Consensus 2025. |
| 掲載誌名 | 正式名：Schizophrenia (Heidelberg, Germany) 略 称：Schizophrenia (Heidelb) ISSNコード：27546993/27546993 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.Online ahead of print |
| 著者・共著者 | Yoshiteru Takekita, Hideaki Tani, Yasushi Kawamata, Asuka Katsuki, Hiroyuki Muraoka, Shinichiro Ochi, Hiromi Tagata, Kyosuke Sawada, Akira Nishi, Saki Hattori, Toshiaki Kikuchi, Hajime Baba, Masaki Kato, Koichiro Watanabe, Ken Inada, Norio Yasui-Furukori, Hitoshi Sakurai, Jun-Ichi Iga |
| 発行年月 | 2026/06 |
| 概要 | Conventional schizophrenia treatment guidelines do not adequately address all clinically important issues in routine practice. This study aimed to update the 2021 expert consensus of the Japanese Society of Clinical Neuropsychopharmacology (JSCNP) to reflect the current clinical landscape. A total of 154 board-certified psychiatrists from the JSCNP and the Japanese Society of Neuropsychopharmacology (JSNP) evaluated treatment options across 21 clinically relevant situations using a 9-point Likert scale (1 = "strongly disagree"; 9 = "strongly agree"); the response rate was 44%. First-line antipsychotics varied by predominant symptoms: risperidone, brexpiprazole, olanzapine, paliperidone, and blonanserin for positive symptoms; aripiprazole and brexpiprazole for negative symptoms and cognitive impairment; aripiprazole, brexpiprazole, lurasidone, olanzapine, and quetiapine for depression and anxiety; brexpiprazole, aripiprazole, and olanzapine for disorganized thinking; olanzapine and risperidone for excitement and aggression; and aripiprazole, brexpiprazole, and lurasidone for social integration. Brexpiprazole, quetiapine, and aripiprazole were first-line options for patients at high risk of extrapyramidal side effects or diabetes mellitus. Dose reduction or switching was the treatment of choice for tardive dyskinesia. Repeated recurrence, patient request, and poor medication adherence were indications for introducing long-acting injectable antipsychotics. Switching to clozapine was the treatment of choice for treatment-resistant schizophrenia. Adverse effects were the highest-rated factor for both dose reduction and simplification to antipsychotic monotherapy. Second-generation antipsychotics were rated as first- or second-line options in most situations, whereas first-generation antipsychotics were generally rated as third-line. These recommendations provide practical guidance for treatment selection and shared decision-making in clinically challenging situations not adequately addressed by existing evidence alone. |
| DOI | 10.1038/s41537-026-00770-x |
| PMID | 42230659 |