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2. Psychopharmacology Algorithms: Schizophrenia
David N. Osser, MD,
Associate Professor of Psychiatry
Harvard Medical School
Brockton Division of the VA Boston Healthcare System
General Editor - Psychopharmacology Algorithm Project
Harvard South Shore Residency Training Program

3. More complicated situations
Treatment resistance
Patients never previously treated with an antipsychotic (first onset)

4. More complicated situations
Treatment resistance
Patients never treated with an antipsychotic (first onset)
Practical strategies

5. Importance of effectiveness Equally important: long-term side effects

6. Greater emphasis on milder side effects profile
First Trial
Greater emphasis on milder side effects profile

7. Greater emphasis on efficacy
First Trial
Second Trial
Greater emphasis on efficacy
Greater emphasis on milder side effects profile
Toxicity awareness

8. Recommendations based on knowledge of the evidence base
Clinical experience is considered in decision making
He/she gives a recommendation or asks more questions
When the evidence is limited: conservative and flexible approaches
Questions to a psychopharmacology consultant

9. Recommendations based on knowledge of the evidence base
Clinical experience is considered in decision making
He/she gives a recommendation or asks more questions
When the evidence is limited: conservative and flexible approaches
Questions to a psychopharmacology consultant

10. Recommendations based on knowledge of the evidence base
Clinical experience is considered in decision making
He/she asks more questions or gives a recommendation
When the evidence is limited: conservative and flexible approaches
Questions to a psychopharmacology consultant

11. Recommendations based on knowledge of the evidence base
Clinical experience is considered in decision making
He/she asks more questions or gives a recommendation
When the evidence is limited: conservative and flexible approaches
Questions to a psychopharmacology consultant

12. Clinician user of this algorithm
Willingness to be guided by the evidence
Awareness of the complexity of cases
Recognition of perils of unsystematic approaches
Clinician user of this algorithm

13. Unique characteristics of each case
Decision making in EBM
Clinician experience
Patient preferences
Unique characteristics of each case

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