INTEGRATE: international guidelines for the algorithmic treatment of schizophrenia.
McCutcheon RA., Pillinger T., Varvari I., Halstead S., Ayinde OO., Crossley NA., Correll CU., Hahn M., Howes OD., Kane JM., Kabir T., Konradsson-Geuken Å., Lennox B., Hui CLM., Rossell SL., Solmi M., Sommer IE., Taipale H., Uchida H., Venkatasubramanian G., Warren N., INTEGRATE Advisory Group None., Siskind D.
Schizophrenia is a mental illness involving multiple symptom domains and is often associated with substantial physical health comorbidities. Guidelines exist, but these tend to be country-specific and are often missing a concise yet comprehensive algorithmic approach. From May 1, 2023, to Jan 1, 2025, International Guidelines for Algorithmic Treatment (INTEGRATE) authors from all UN regions collaborated to develop a consensus guideline focused on the pharmacological treatment of schizophrenia. Following an umbrella review of the literature, input from expert workshops, a consensus survey, and lived experience focus groups, a consensus algorithmic guideline and associated digital tool were developed. Key recommendations include a focus on metabolic health from treatment initiation, timely assessment and management of non-response, symptom domain-specific interventions, mitigation of side-effects, and the prompt use of clozapine in cases of treatment resistance.