Clinical effectiveness in adults with chronic schizophrenia

Schizophrenia is a severe, debilitating mental illness characterised by a progressive decline of the patient's functioning and relationship with the outside world. Although some patients recover, the illness more usually follows a chronic relapsing course. The long-standing nature of the illness gives rise to a variety of issues, such as poor general health and non-adherence to treatment, which can have a significant impact on the clinical effectiveness of antipsychotic therapy. It is therefore important that clinicians consider the wider aspects of clinical effectiveness, such as functional recovery, individual well-being, treatment adherence and patient satisfaction, when assessing the clinical effectiveness of antipsychotic therapy. Of the atypical antipsychotics currently available to treat chronic schizophrenia, clinical experience and results from clinical trials suggest that quetiapine can provide a broad range of symptomatic relief with minimal clinically significant adverse events. This, in turn, may lead to greater patient satisfaction, increased adherence and an improved treatment outcome. As with all atypical antipsychotics, the key to clinical effectiveness is appropriate dosing. Data from recent studies suggest that an appropriate target dose for quetiapine for many adults with schizophrenia is 600 mg/day.