Evidence-based interventions for schizophrenia

EBI-SCZ: Evidence-Based Interventions for Schizophrenia

Schizophrenia

Amisulpiride is an antipsychotic that acts on the dopamine system as a pre-synaptic antagonist.

Amitriptyline is a tricyclic antidepressant that acts on the histamine and serotonin systems as an antagonist.

Aripiprazole is an antipsychotic that acts on the dopamine and serotonin systems as a partial agonist.

Aripiprazole LAI is a long-acting injectable (depot) formulation of aripiprazole, an antipsychotic that acts on the dopamine and serotonin systems as a partial agonist.

Asenapine is an antipsychotic that acts on the dopamine, serotonin and norepinephrine systems as an antagonist.

Atomoxetine is a non-stimulant medication that acts on the norepinephrine system as a reuptake inhibitor.

Baclofen is a muscle relaxant that acts on the GABA system as an agonist.

Blonanserin is an antipsychotic that acts on the dopamine and serotonin systems as an antagonist.

Brexpiprazole is an antipsychotic that acts on the dopamine and serotonin systems as a partial agonist.

Bupropion is a medication primarily FDA-approved for depression and smoking cessation, though it is used off-label for ADHD. It functions by inhibiting the reuptake of dopamine and norepinephrine to potentially improve attention and focus. While generally considered safe, it requires monitoring for side effects such as insomnia, dry mouth, and an increased risk of seizures.

Cariprazine is an antipsychotic that acts on the dopamine and serotonin systems as a partial agonist and antagonist.

Chlorpromazine is an antipsychotic that acts on the dopamine and serotonin systems as an antagonist.

Clozapine is an antipsychotic that acts on the dopamine, serotonin and norepinephrine systems as an antagonist.

Dextroamphetamine is a stimulant that acts on the dopamine and norepinephrine systems through multiple mechanisms.

Diphenhydramine is an antihistamine that acts on the histamine system as an antagonist.

Doxepin is a tricyclic antidepressant that acts on the histamine system as a receptor antagonist.

Flupenthixol is an antipsychotic that acts on the dopamine and serotonin systems as an antagonist.

Flupenthixol LAI is a long-acting injectable (depot) formulation of flupenthixol, an antipsychotic that acts on the dopamine and serotonin systems as an antagonist.

Fluphenazine is an antipsychotic that acts on the dopamine system as an antagonist.

Fluphenazine LAI is a long-acting injectable (depot) formulation of fluphenazine, an antipsychotic that acts on the dopamine system as an antagonist.

Haloperidol is an antipsychotic that acts on the dopamine system as an antagonist.

Haloperidol LAI is a long-acting injectable (depot) formulation of haloperidol, an antipsychotic that acts on the dopamine system as an antagonist.

Iloperidone is an antipsychotic that acts on the serotonin and dopamine systems as an antagonist.

KarXT is an antipsychotic that acts on the acetylcholine system as a muscarinic M1 and M4 receptor agonist.

Levomepromazine is an antipsychotic that acts on the dopamine and serotonin systems as an antagonist.

Lithium is a mood stabiliser; it is thought to act by modulating intracellular signalling enzymes.

Loxapine is an antipsychotic that acts on the dopamine and serotonin systems as an antagonist.

Lumateperone is an antipsychotic that acts on the serotonin and dopamine systems through multiple mechanisms.

Lurasidone is an antipsychotic that acts on the dopamine and serotonin systems as an antagonist.

Methylphenidate is an FDA-approved stimulant medication widely used as a first-line treatment for ADHD. It functions by inhibiting the reuptake of dopamine and norepinephrine to regulate inattention and impulsivity. Like other stimulants, it is a controlled substance requiring close monitoring due to abuse potential and side effects (e.g., appetite suppression, and sleep disruption).

Olanzapine is an antipsychotic that acts on the dopamine and serotonin systems as an antagonist.

Olanzapine LAI is a long-acting injectable (depot) formulation of olanzapine, an antipsychotic that acts on the dopamine and serotonin systems as an antagonist.

Olanzapine-samidorphan is an antipsychotic that acts on the dopamine, serotonin and opioid systems as a receptor antagonist.

Oxytocin is a neuropeptide hormone that plays a crucial role in social bonding, trust, and emotional regulation. It is naturally produced in the hypothalamus and released into the bloodstream and brain, where it influences various aspects of social behavior. In clinical settings, oxytocin is mainly administered intranasally to target the central nervous system directly. 

Due to its significant role in social cognition and behavior, oxytocin has been studied as a potential therapeutic agent for Autism Spectrum Disorder (ASD) with the aim of improving social functioning. Nasal administration allows oxytocin to cross the blood-brain barrier more efficiently, facilitating its action on brain regions involved in social cognition. 
Interventions based on intranasal oxytocin administration are grounded in its involvement in enhancing social cognition, including theory of mind and empathy (Hammock et al., 2015). The proposed mechanisms of action include: 
+Fear Reduction: Oxytocin may reduce fear and anxiety, making social interactions less intimidating and more manageable for individuals with ASD.
+Increased Social Motivation: By enhancing the reward system associated with social interactions, oxytocin may increase the desire to engage in social activities.
+Improved Detection of Social Cues: Oxytocin might enhance the ability to recognize and interpret social signals, such as facial expressions and body language, thereby improving social communication.

Commonly, oxytocin is administered in dosages ranging from 18 to 40 international units (IU) per day, divided into multiple doses. It is essential for these interventions to be supervised by healthcare professionals to ensure safety and monitor for any potential side effects, such as nasal irritation or headaches.

Paliperidone is an antipsychotic that acts on the dopamine, serotonin and norepinephrine systems as an antagonist.

Paliperidone LAI is a long-acting injectable (depot) formulation of paliperidone, an antipsychotic that acts on the dopamine, serotonin and norepinephrine systems as an antagonist.

Perospirone is an antipsychotic that acts on the dopamine and serotonin systems as an antagonist.

Perphenazine is an antipsychotic that acts on the dopamine system as an antagonist.

Pimozide is an antipsychotic that acts on the dopamine system as an antagonist.

Quetiapine is an antipsychotic that acts on the norepinephrine system as a reuptake inhibitor and presynaptic receptor antagonist.

Risperidone is an antipsychotic that acts on the dopamine and serotonin systems as an antagonist.

Risperidone LAI is a long-acting injectable (depot) formulation of risperidone, an antipsychotic that acts on the dopamine and serotonin systems as an antagonist.

Sertindole is an antipsychotic that acts on the dopamine and serotonin systems as an antagonist.

Sodium valproate is an anticonvulsant and mood stabiliser; its precise mechanism of action is not fully established.

Sulpiride is an antipsychotic that acts on the dopamine system as an antagonist.

Thioridazine is an antipsychotic that acts on the dopamine and serotonin systems as an antagonist.

Trifluoperazine is an antipsychotic that acts on the dopamine and serotonin systems as an antagonist.

Varenicline is a smoking-cessation aid that acts on the acetylcholine system as a partial agonist.

Xanomeline- trospium is an antipsychotic that acts on the acetylcholine system as a muscarinic M1 and M4 receptor agonist.

Xanomeline-trospium chlorate is an antipsychotic that acts on the acetylcholine system as a muscarinic M1 and M4 receptor agonist.

Ziprasidone is an antipsychotic that acts on the dopamine and serotonin systems as an antagonist.

Zotepine is an antipsychotic that acts on the dopamine and serotonin systems as an antagonist.

Zuclopenthixol is an antipsychotic that acts on the dopamine system as an antagonist.

Legend

Intervention effect compared to placebo or other controls

Evidence Quality (how confident we are in the finding)