NICE issues new guidelines for the treatment of schizophrenia

The National Institute for Health and Clinical Excellence (NICE) has updated its guidelines on the best way to treat and manage adults with schizophrenia in primary and secondary care.

The new guidance updates the previous clinical guideline and also their recommendations on the use of newer (atypical) antipsychotic drugs for the treatment of schizophrenia.

Key recommendations, which were published on March 25th, state that:

• Healthcare professionals should ensure they are competent in working with people with schizophrenia from diverse ethnic and cultural backgrounds.

• Mental health services should work in partnership with local organisations, including those representing BME groups, to enable people with schizophrenia to access local employment and educational opportunities.

• Cognitive behavioural therapy (CBT) should be offered to all people with schizophrenia. NICE also states that social, group and physical activities such as exercise should be offered and recorded in the patient's care plan.

• Family intervention to all families of people with schizophrenia who live with or are in close contact with the service user should be available.

• For people with newly diagnosed schizophrenia, oral antipsychotic medication should be offered. Information and discussion of the benefits and side-effect profile of each drug with the service user should also be provided. The choice of drug should be made by the service user and healthcare professional together.

• People with schizophrenia are at higher risk of cardiovascular disease than the general population so GPs and other primary healthcare professionals should monitor the physical health of people with schizophrenia at least once a year with a focus on cardiovascular disease risk assessment.

• The provision of arts therapies to all people with schizophrenia, particularly for the alleviation of negative symptoms should be considered.

Commenting on the new guidelines, which apply to people with schizophrenia in the NHS in Wales and England, Hafal Deputy Chief Executive Alun Thomas said: "We welcome NICE's review and update. It reinforces the previous guidelines by emphasising service user choice based on the need for a full and clear discussion on the possible side-effects of the drugs which are recommended for treatment.

"Hafal believes that the newer and more modern medication will remain the first choice for patients because they have lesser side-effects. We think it's also very important for prescribers to remember that cost should not be an issue when discussing medication. Hafal believes it's for the patient to judge which is the best choice for them, even if this might mean more expense for the NHS. Service users should not be afraid to politely challenge doctors if they believe cost is an issue."

The new NICE guidelines on Schizophrenia can be viewed here: http://www.nice.org.uk/CG082