The recent Psych Congress 2023 brought together experts in the field of psychiatry, shedding light on the current state of schizophrenia research. Among the speakers was Dr. Peter Weiden, a clinical professor of psychiatry at the Renaissance School of Medicine at Stony Brook University in New York. In his session titled “State of the Science: Focus on Schizophrenia,” Dr. Weiden shared valuable insights into the latest research findings and emerging treatments for this complex psychiatric disorder.
During a MedPage Today video interview, Dr. Weiden advised clinicians to prepare for the arrival of new treatment options in the coming years. While cautioning against making unrealistic promises to patients, he emphasized the importance of staying informed and proactive in the meantime. Drawing from his own experience, Dr. Weiden revealed that he turned to YouTube as a valuable resource for expanding his knowledge. He discussed how he explored new receptors and drugs in different areas of medicine through online classes available on the platform. This experience allowed him to witness firsthand the incredible advancements in medical mechanisms.
Dr. Weiden highlighted the likelihood that the first wave of new non-dopamine antipsychotics to enter the market would be muscarinic receptor agonists. To familiarize themselves with this upcoming development, clinicians were encouraged to dive into the world of acetylcholinesterase inhibitors, commonly used for Alzheimer’s disease. Understanding the role of muscarinic receptors both in the brain and in the periphery can provide valuable insights into the potential benefits and side effects of these emerging treatments. Dr. Weiden stressed that our knowledge of muscarinic systems has expanded significantly, revealing the detrimental effects of central anticholinergic activity. Acknowledging the negative impact on cognition and overall well-being, he urged clinicians to assess the anticholinergic burden their prescriptions may place on patients.
Continuing the discussion on anticholinergic activity, Dr. Weiden addressed the need to reconsider the use of benztropine (Cogentin). Traditionally prescribed to manage extrapyramidal symptoms (EPS), this medication’s necessity has diminished over time. Dr. Weiden referred to it as “outdated” and suggested exploring alternative approaches to reduce the anticholinergic burden on patients. The potential risks associated with medications like Haldol (haloperidol), once considered safe, were highlighted, emphasizing the increased reliance on benztropine to counteract adverse effects. By reassessing the necessity of such medications and exploring alternatives, clinicians can minimize the overall anticholinergic burden on patients.
Dr. Weiden concluded his remarks by assuring clinicians that there is much more to come in terms of advancements in schizophrenia treatment. With ongoing research and scientific progress, the field is poised to witness significant breakthroughs. He expressed gratitude to the audience for their attention and encouraged them to stay tuned for further developments.
Dr. Peter Weiden’s session at the Psych Congress 2023 provided valuable insights into the state of the science surrounding schizophrenia. His emphasis on preparing for upcoming treatment options, diving into muscarinic receptor research, reconsidering the use of benztropine, and minimizing anticholinergic burden on patients provided clinicians with actionable guidance. As the field of psychiatry continues to evolve, staying informed and proactive becomes essential to improving patient outcomes and advancing the understanding and management of schizophrenia.
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