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CME: Addressing barriers to optimal care in schizophrenia with pharmacotherapy


Activity Description / Statement of Need:

Schizophrenia is a mental health disorder characterized by disrupted neurochemical pathways, thought processes, emotions, and social interactions. While schizophrenia is a heterogeneous disease both across and within patients, it is nonetheless a debilitating disorder for many individuals. An estimated 0.25% to 0.75% of the population suffer from schizophrenia, resulting in about 20.9 million cases and 13.4 million years of life lived with disability worldwide. The goals of treatment for schizophrenia should include not only reducing the number of acute psychotic episodes and reducing the risk for future relapse but also improving quality of life and function beyond symptom relief, such as outcomes related to school, work, and relationships. To achieve these goals, a combination of pharmacologic and non-pharmacologic interventions are recommended. Although current guidelines are explicit about the importance of engaging patients in goal setting and valuing patient preferences, psychiatrists not uncommonly undervalue the importance of improving daily living and capacity for work, suggesting an important practice gap.

Target Audience:

Psychiatrists and primary care physicians; nurse practitioners, physician assistants, and pharmacists who specialize in psychiatry; and those who otherwise commonly care for or clinically encounter patients who have schizophrenia.

This program is supported by an educational grant from Indivior.

Learners may participate in this activity free of charge.

Release Date: November 27, 2020 -- Expiration Date: November 27, 2022

Faculty: Joseph Pierre, MD


Faculty introduction, disclosures

Primer on schizophrenia

  • Epidemiology and statistics
  • Pathophysiological development and progression
    • Role of receptors
    • Mechanism of action of first- and second-generation antipsychotics
  • Comorbid neuropsychiatric conditions
  • Diagnostic criteria
  • Differential diagnosis

Updates in schizophrenia treatment and strategies for barriers to care

  • Pharmacotherapy
    • Acute
    • Maintenance
    • The role of adjunctive treatment
    • Targeting positive vs negative symptoms
    • Treatment principles for refractory disease
  • Emerging treatment options and trends
    • Novel therapies
    • Fixed-dose combinations
    • Long-acting injectables
  • 2020 APA guidelines
    • Recommendations
    • Individualizing care
    • Clinical pearls
  • Treatment principles that take consider barriers to care
    • Adherence
    • Adverse event management and mitigation
    • Forming a therapeutic alliance
  • Best practice: Putting it all together
  • Patient cases

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Describe challenges to the successful management of schizophrenia relating to treatment adherence and develop corresponding solutions.
  • Prioritize agents from both first- and second-generation antipsychotics, given a patient case and using patient-centered decision-making.
  • Describe the ways in which understanding of schizophrenia neuropathology has changed and pair that knowledge with treatment mechanisms.
  • List present and emerging treatment options for schizophrenia, including those targeted at negative symptoms and apply them to patient cases using evidence-based medicine.


ACCME Activity #201861266


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.

Faculty Disclosure: Joseph M. Pierre, MD, Clinical Professor, Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, has no relevant conflicts of interest to disclose.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, CEO of ScientiaCME, has no relevant conflicts of interest to disclose.

Disclosures of Peer Reviewers:
Roberto Castaños, MD, has no relevant conflicts of interest to disclose.
Ira D. Glick, MD is a stockholder of Johnson and Johnson and has no relevant conflicts of interest to disclose.

Commercial Support Disclosure: This program is supported by an educational grant from Indivior.


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

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