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Can clinical practice guide a research agenda?

Stephen R Marder1

  • 1VA Desert Pacific Mental Illness Research Education and Clinical Center, West Los Angeles VA Health Care Center, CA 90073, USA. marder@ucla.edu

Schizophrenia Bulletin
|June 6, 2002
PubMed

Insights

Clinicians often use treatments not backed by evidence, like multiple antipsychotics or delayed clozapine use. These common practices highlight key areas for future clinical research and evidence generation.

Area of Science:

  • Psychiatry and Clinical Practice
  • Evidence-Based Medicine
  • Pharmacological Research

Background:

  • Current clinical practice in psychiatry shows frequent adoption of treatments lacking robust evidence.
  • Specific examples include polypharmacy with antipsychotics and restricted use of clozapine.

Discussion:

  • This commentary examines the gap between clinical practice and evidence-based guidelines.
  • It highlights the need to critically evaluate common treatment approaches in psychiatry.
  • The commentary proposes that prevalent, unsupported practices can inform research agendas.

Key Insights:

  • Clinicians are frequently employing antipsychotic polypharmacy without strong supporting evidence.
  • The delayed initiation of clozapine for treatment-resistant schizophrenia is a common, yet unsupported, practice.
  • These deviations from evidence-based medicine represent critical areas for further investigation.

Outlook:

  • Future research should focus on generating evidence for or against current common practices.
  • Investigating the efficacy and safety of antipsychotic polypharmacy is warranted.
  • Research is needed to determine optimal timing and patient selection for clozapine treatment.

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