Evidence map›Paper›PMID 40580548›Full record

GuidelineSchizophrenia bulletin2025

Pharmacological and Somatic Treatments for First-Episode Psychosis and Schizophrenia: Synopsis of the US Department of Veterans Affairs and US Department of Defense Clinical Practice Guidelines.

Robert W Buchanan, Ira Katz, Fuad Issa, Rachael Coller, Matthew A Fuller, Jennifer Ballard-Hernandez, James Sall, Richard Goldberg, James T Reston, Shannon C Ford and 1 more

Abstract readPractice Guideline
In one paragraph

Guideline in Schizophrenia bulletin, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. The Australian and New Zealand journal of psychiatry · 2026
    Guideline
  2. Should Residents Be Required to Administer Long-Acting Injectables?Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Robert W BuchananVA Capitol Mental Illness Research, Education and Clinical Center (MIRECC), Baltimore VA Medical Center, Baltimore, MD, United States.
Ira KatzU.S. Department of Veterans Affairs, Office of Mental Health, Washington, DC, United States.
Fuad IssaDefense Health Agency, Psychological Health Center of Excellence, Silver Spring, MD, United States.
Rachael CollerU.S. Department of Veterans Affairs, Mann-Grandstaff VA Medical Center, Spokane, WA, United States.
Matthew A FullerU.S. Department of Veterans Affairs, VHA Pharmacy Benefits Management Services, Washington, DC, United States.
Jennifer Ballard-HernandezU.S. Department of Veterans Affairs, Evidence Based Practice Program, Washington, DC, United States.
James SallU.S. Department of Veterans Affairs, Evidence Based Practice Program, Washington, DC, United States.
Richard GoldbergVA Capitol Mental Illness Research, Education and Clinical Center (MIRECC), Baltimore VA Medical Center, Baltimore, MD, United States.
James T RestonECRI Institute, Plymouth Meeting, PA, United States.
Shannon C FordWalter Reed National Military Medical Center Bethesda, Bethesda, MD, United States.
Noosha NivVA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), Long Beach VA Healthcare System, Long Beach, CA, United States.

Funding

U.S. Department of Veterans Affairs
6 · The paper itself

Abstract

backgroundThe Departments of Veterans Affairs (VA) and Defense (DOD) provide care each year for approximately 75,000 people with first-episode psychoses or schizophrenia, but neither has formal, evidence-based guidance for treating these conditions. Recognition of this gap, together with guidance from Congress, led the Departments to develop clinical practice guidelines for first-episode psychosis and schizophrenia. This synopsis summarizes the psychopharmacological and other somatic treatment recommendations. STUDY

designAn interdisciplinary panel of VA and DOD mental health and primary care providers was created following methods specified by the VA/DOD Evidence-Based Practice Guideline Work Group. The panel formulated key questions that guided a comprehensive search of the intervention literature from November 2011 to December 2021, with evidence limited to findings from randomized clinical trials. Recommendations were based on evaluation of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods. STUDY

resultsThe VA/DOD guideline panel developed 15 pharmacological and somatic treatment recommendations, including those on antipsychotic medication use for the treatment of first-episode psychosis and schizophrenia, use of clozapine for treatment-resistant schizophrenia, treatment of clozapine non-responders, and side effect management. There was insufficient evidence to provide recommendations for or against the use of non-antipsychotic medications or somatic treatments to treat negative or cognitive symptoms.

conclusionsThe VA/DOD guideline panel developed 15 pharmacological and somatic treatment recommendations to promote optimal, evidence-based care for active service members and Veterans. However, there remain multiple treatment planning decision points for which there is a lack of data and/or effective treatments.

Indexed as

Antipsychotic AgentsPsychotic DisordersSchizophreniaHumansUnited StatesUnited States Department of DefenseUnited States Department of Veterans AffairsAntipsychotic Agentsantipsychotic agentsevidence-based practicesservice memberssystematic reviewtreatment algorithmtreatment guidelinesveterans

Identifiers

PMID40580548
PMCPMC12236308

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.