Guidelines for the Pharmacotherapy of Schizophrenia in Adults

Can J Psychiatry. 2017 Sep;62(9):604-616. doi: 10.1177/0706743717720448. Epub 2017 Jul 13.


Objective: The present guidelines address the pharmacotherapy of schizophrenia in adults across different stages, phases, and symptom domains.

Method: Guidelines were developed using the ADAPTE process, which takes advantage of existing guidelines. Six guidelines were identified for adaptation, with recommendations extracted from each. For those specific to the pharmacotherapy of schizophrenia in adults, a working group selected between guidelines and recommendations to create an adapted guideline.

Results: Recommendations can be categorized into 6 areas that include 1) first-episode schizophrenia, 2) acute exacerbation, 3) relapse prevention and maintenance treatment, 4) treatment-resistant schizophrenia, 5) clozapine-resistant schizophrenia, and 6) specific symptom domains. For each category, recommendations are made based on the available evidence, which is discussed and linked to other established guidelines.

Conclusions: In most cases, evidence-based recommendations are made that can be used to guide current clinical treatment and decision making. Notably, however, there is a paucity of established evidence to guide treatment decision making in the case of clozapine-resistant schizophrenia, a subsample that represents a sizable proportion of those with schizophrenia.

Keywords: adult psychiatry; antipsychotics; clinical practice guideline; pharmacotherapy; schizophrenia; systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Antipsychotic Agents / therapeutic use*
  • Canada
  • Evidence-Based Medicine / standards*
  • Humans
  • Practice Guidelines as Topic / standards*
  • Schizophrenia / drug therapy*


  • Antipsychotic Agents