CNS Spectrums


“Meta-guidelines” for the management of patients with schizophrenia

Stephen M. Stahla1a2a3a4 c1, Debbi A. Morrissettea3, Leslie Citromea5, Stephen R. Saklada6a7a8, Michael A. Cummingsa4, Jonathan M. Meyera1a4, Jennifer A. O'Daya4, Laura J. Dardashtia4 and Katherine D. Warburtona4

a1 Department of Psychiatry, University of California–San Diego, San Diego, California, USA

a2 Department of Psychiatry, University of Cambridge, Cambridge, UK

a3 Neuroscience Education Institute, Carlsbad, California, USA

a4 California Department of State Hospitals, Sacramento, California, USA

a5 New York Medical College, Valhalla, New York, USA

a6 San Antonio State Hospital, Texas Department of State Health Services, San Antonio, Texas, USA

a7 College of Pharmacy, Pharmacotherapy Division, The University of Texas at Austin, Austin, Texas, USA

a8 School of Medicine, University of Texas Health Science Center, San Antonio, Texas, USA


Guidelines for treating various conditions can be helpful in setting practice standards, but the presence of several sets of guidelines from different countries, experts, and settings, written at different times, can also create confusion. Here we provide a “guideline of guidelines” for the treatment of schizophrenia, or “meta-guidelines,” which not only reconcile the various existing standards but also update them to include the use of several newer agents, most of which were marketed following the publication of existing standards.

(Received July 01 2012)

(Accepted January 24 2013)

(Online publication April 16 2013)

Key words

  • Assessment;
  • acute;
  • maintenance;
  • antipsychotics;
  • depot


c1 Address for correspondence: Stephen M. Stahl, MD, PhD, 1930 Palomar Point Way, Suite 103, Carlsbad, CA 92008, USA. (Email