[Recent developments in the antipsychotic treatment of schizophrenia]

This publication is an expanded and updated version of three topics selected from a lecture, which was pre sented at a continuing medical education event held in Spring 2025 at the Department of Psychiatry and Psycho therapy at Semmelweis University. The three topics are: 1. The value and usefulness of Real World Data (RWD) and Real World Evidence (RWE) in the treatment of schizophre nia. We highlight RWD and RWE on the efficacy of combined antipsychotic treatments (polypharmacy), and a publi cation on a potentially serious adverse reaction (breast cancer) identified using a Finnish national database. 2. Recent developments, professional opinions and regulatory actions on the use of clozapine. In the USA, new regula tions have already been introduced in summer 2025, with a reduction in the number of blood count (absolute neutrophil granulocyte count) checks. In Europe, preparations are underway at the time of the writing of this manuscript. 3. The efficacy of placebo in the treatment of negative symptoms of schizophrenia. Almost all investigational drugs developed for the treatment of negative symptoms of schizophrenia have been tested with negative results over the last 20-30 years. The main reason for this was the high placebo response rate, which suggests that at least part of the tested negative symptoms were not theatment resistant. Considering the evidence that several psychosocial interventions have been shown to be significantly more effective than standard treatments in treating negative symptoms of schizophrenia, it is justified to accurately assess and treat negative symptoms. Keywords: schizophrenia; real world data; real world evidence; clozapine; negative symptoms; placebo response.