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CME / CE

What's the Latest in Schizophrenia? Key Takeaways From an Expert Consensus Panel

  • Authors: Alan Breier, MD
  • CME / CE Released: 5/25/2023
  • Valid for credit through: 5/25/2024
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  • Credits Available

    Physicians - maximum of 1.00 AMA PRA Category 1 Credit(s)™

    Nurses - 1.00 ANCC Contact Hour(s) (0.5 contact hours are in the area of pharmacology)

    You Are Eligible For

    • Letter of Completion

Target Audience and Goal Statement

This activity is intended for psychiatrists, primary care physicians, emergency medicine physicians, obstetrician/gynecologists, nurse practitioners, physician assistants, nurses, and other clinicians who treat patients with schizophrenia.

The goal of this activity is for learners to better recognize the current advancements in schizophrenia treatments and appreciate the role of nondopamine (non-DA) antipsychotics in the future care of patients with schizophrenia.

Upon completion of this activity, participants will:

  • Have increased knowledge regarding the
    • Clinical limitations of currently available antipsychotic medications
    • Unmet needs in schizophrenia care
  • Demonstrate greater confidence in their ability to
    • Communicate with patients regarding their unmet needs in the management of schizophrenia


Disclosures

Medscape, LLC requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.


Faculty

  • Alan Breier, MD

    Professor of Psychiatry
    Indiana University School of Medicine
    Indianapolis, Indiana

    Disclosures

    Alan Breier, MD, has the following relevant financial relationships:
    Consultant or advisor for: Arrivo Bioventures; BioXcel Therapeutics; Karuna Therapeutics; Neumarker Inc.; Perception Neuroscience; Sirtsei Pharmaceuticals, Inc.
    Stock options from: Karuna Therapeutics; Perception Neuroscience
    Owns stock (publicly traded) in: Karuna Therapeutics

Editors

  • Frances McFarland, PhD, MA

    Medical Education Director, Medscape, LLC

    Disclosures

    Frances McFarland, PhD, MA, has no relevant financial relationships.

  • Megan Breuer, PhD

    Medical Writer, Medscape, LLC

    Disclosures

    Megan Breuer, PhD, has the following relevant financial relationships:
    Consultant/advisor for Paratek Pharmaceuticals, Inc. (former)

Compliance Reviewer/Nurse Planner

  • Leigh Schmidt, MSN, RN, CNE, CHCP

    Associate Director, Accreditation and Compliance, Medscape, LLC

    Disclosures

    Leigh Schmidt, MSN, RN, CNE, CHCP, has no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has no relevant financial relationships.


Accreditation Statements



In support of improving patient care, Medscape, LLC is jointly accredited with commendation by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

    For Physicians

  • Medscape, LLC designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    College of Family Physicians of Canada Mainpro+® participants may claim certified credits for any AMA PRA Category 1 credit(s)™, up to a maximum of 50 credits per five-year cycle. Any additional credits are eligible as non-certified credits. College of Family Physicians of Canada (CFPC) members must log into Mainpro+® to claim this activity.

    Contact This Provider

    For Nurses

  • Awarded 1.0 contact hour(s) of nursing continuing professional development for RNs and APNs; 0.50 contact hours are in the area of pharmacology.

    Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]


Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

  1. Read about the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or print it out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.

CME / CE

What's the Latest in Schizophrenia? Key Takeaways From an Expert Consensus Panel

Authors: Alan Breier, MDFaculty and Disclosures

CME / CE Released: 5/25/2023

Valid for credit through: 5/25/2024

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References

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  2. Carbon M, et al. Thinking and acting beyond the positive: the role of the cognitive and negative symptoms in schizophrenia. CNS Spectr. 2014;19:38-52.
  3. Correll CU, et al. Cariprazine in the management of negative symptoms of schizophrenia: state of the art and future perspectives. Future Neurol. 2020;15:FNL52.358.
  4. McCutcheon RA, et al. Schizophrenia, dopamine and the striatum: from biology to symptoms. Trends Neurosci. 2019;42:205-220.
  5. McCutcheon RA, et al. Schizophrenia—an overview. JAMA Psychiatry. 2020;77:201-210.
  6. Kahn RS, et al. Schizophrenia. Nat Rev Dis Primers. 2015;1:15067.
  7. Harvey PD, et al. Addressing patients' unmet needs to improve outcomes in schizophrenia. J Clin Psychiatry. 2021;82:IC20018AH3C.
  8. Torres-González F, et al. Unmet needs in the management of schizophrenia. Neuropsychiatr Dis Treat. 2014;10:97-110.
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  10. American Psychiatric Association (APA). The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia. 3rd ed. American Psychiatric Association Publishing; 2021.
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  12. Correll CU, et al. Emerging treatments in schizophrenia. J Clin Psychiatry. 2022;83:SU21204IP1.
  13. Huhn M, et al. Comparative efficacy and tolerability of 32 oral antipsychotics for the acute treatment of adults with multi-episode schizophrenia: a systematic review and network meta-analysis. Lancet. 2021;394:939-951.
  14. Corponi F, et al. Novel antipsychotics specificity profile: a clinically oriented review of lurasidone, brexpiprazole, cariprazine and lumateperone. Eur Neuropsychopharmacol. 2019;29:971-985.
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  17. Loebel A, et al. Effectiveness of lurasidone vs. quetiapine XR for relapse prevention in schizophrenia: a 12-month, double-blind, noninferiority study. Schizophr Res. 2013;147:95-102.
  18. Harvey PD, et al. Effect of lurasidone dose on cognition in patients with schizophrenia: post-hoc analysis of a long-term double-blind continuation study. Schizophr Res. 2015;166:334-338.
  19. Correll CU, et al. Safety and tolerability of lumateperone 42 mg: an open-label antipsychotic switch study in outpatients with stable schizophrenia. Schizophr Res. 2021;228:198-205.
  20. Lieberman JA, et al. ITI-007 for the treatment of schizophrenia: a 4-week randomized, double-blind, controlled trial. Biol Psychiatry. 2016;79:952-961.
  21. Németh G, et al. Cariprazine versus risperidone monotherapy for treatment of predominant negative symptoms in patients with schizophrenia: a randomised, double-blind, controlled trial. Lancet. 2017;389:1103-1113.
  22. Correll CU, et al. Effects of olanzapine combined with samidorphan on weight gain in schizophrenia: a 24-week phase 3 study. Am J Psych. 2020;177:1168-1178.
  23. Correll CU, et al. Safety and effectiveness of ulotaront (SEP-363856) in schizophrenia: results of a 6-month, open-label extension study. NPJ Schizophr. 2021;7:63.
  24. Heffernan MLR, et al. Ulotaront: a TAAR1 agonist for the treatment of schizophrenia. ACS Med Chem Lett. 2021;13:92-98.
  25. Breier A, et al. Evidence of trospium's ability to mitigate cholinergic adverse events related to xanomeline: phase 1 study results. Psychopharmacology. 2023;240:1191-1198.
  26. Correll CU, et al. Safety and tolerability of KarXT (xanomeline-trospium) in a phase 2, randomized, double-blind, placebo-controlled study in patients with schizophrenia. Schizophrenia (Heidlb). 2022;8:109.
  27. Brannan SK, et al. Muscarinic cholinergic receptor agonist and peripheral antagonist for schizophrenia. N Engl J Med. 2021;384:717-726.
  28. Weiden PJ, et al. Antipsychotic efficacy of KarXT (xanomeline-trospium): post hoc analysis of positive and negative syndrome scale categorical response rates, time course of response, and symptom domains of response in a phase 2 study. J Clin Psychiatry. 2022;83:21m14316.
  29. Correll CU, et al. Safety and efficacy of KarXT (xanomeline-trospium) in patients with schizophrenia: results from a phase 3, randomised, double-blind, placebo-controlled trial (EMERGENT-2). Presented at: the 35th ECNP Congress; October 15-18, 2022; Vienna, Austria.
  30. Bugarski-Kirola D, et al. Pimavanserin for negative symptoms of schizophrenia: results from the ADVANCE phase 2 randomised, placebo-controlled trial in North America and Europe. Lancet Psychiatry. 2022;9:46-58.
  31. Fleischhacker WW, et al. Efficacy and safety of the novel glycine transporter inhibitor BI 425809 once daily in patients with schizophrenia: a double-blind, randomised, placebo-controlled phase 2 study. Lancet Psychiatry. 2021;8:191-201.
  32. Rosenbrock H, et al. Development of the novel GlyT1 inhibitor, iclepertin (BI 425809), for the treatment of cognitive impairment associated with schizophrenia. Eur Arch Psychiatry Clin Neurosci. 2023. doi:10.1007/s00406-023-01576-z [Epub ahead of print]
  33. de Filippis R, et al. Current and emerging long-acting antipsychotics for the treatment of schizophrenia. Expert Opin Drug Saf. 2021;20:771-790.
  34. Carrithers B, et al. Transdermal asenapine in schizophrenia: a systematic review. Patient Prefer Adherence. 2020;14:1541-1551.
  35. Zhou M, et al. Asenapine transdermal patch for the management of schizophrenia. Psychopharmacol Bull. 2020;50:60-82.
  36. Subotnik KL, et al. Long-acting injectable risperidone for relapse prevention and control of breakthrough symptoms after a recent first episode of schizophrenia: a randomized clinical trial. JAMA Psychiatry. 2015;72:822-829.
  37. Citrome L. Aripiprazole long-acting injectable formulations for schizophrenia: aripiprazole monohydrate and aripiprazole lauroxil. Expert Rev Clin Pharmacol. 2016;9:169-186.
  38. Kane JM, et al. Aripiprazole once-monthly in the acute treatment of schizophrenia: findings from a 12-week, randomized, double-blind, placebo-controlled study. J Clin Psychiatry. 2014;75:1254-1260.
  39. Kane JM, et al. Aripiprazole intramuscular depot as maintenance treatment in patients with schizophrenia: a 52-week, multicenter, randomized, double-blind, placebo-controlled study. J Clin Psychiatry. 2012;73:617-24.
  40. Fleischhacker WW, et al. Long-term safety and tolerability of aripiprazole once-monthly in maintenance treatment of patients with schizophrenia. Int Clin Psychopharmacol. 2013;28:171-176.
  41. Citrome L, et al. Sublingual dexmedetomidine for the treatment of acute agitation in adults with schizophrenia or schizoaffective disorder: a randomized placebo-controlled trial. J Clin Psychiatry. 2022;83:22m14447.
  42. Chien WT, et al. Effects of motivational interviewing-based adherence therapy for schizophrenia spectrum disorders: a randomized controlled trial. Trials. 2015;16:270.
  43. Blackwood C, et al. Patients' preference for long-acting injectable versus oral antipsychotics in schizophrenia: results from the Patient-Reported Medication Preference Questionnaire. Patient Prefer Adherence. 2020;14:1093-1102.
  44. Kraguljac NV, et al. Neuroimaging biomarkers in schizophrenia. Am J Psychiatry. 2021;178:509-521.
  45. Cox D, et al. The potential of immune biomarkers to advance personalized medicine approaches for schizophrenia. J Nerv Ment Dis. 2015;203:393-399.
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