Guidance
Update information
March 2014: A correction was made to the wording of recommendation 1.1.3.3 to clarify that it is the hydrocarbons in cigarette smoke that cause interactions with other drugs, rather than nicotine.
February 2014: We reviewed the evidence and made new recommendations on maintaining and improving physical health, peer support and self-management, preventing psychosis, service-level interventions, employment, education and occupational activities, and supporting carers. These recommendations are marked [2014].
We have also made some changes without an evidence review:
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Some recommendations have been aligned with the NICE guideline on psychosis and schizophrenia in children and young people. This promotes early intervention in psychosis services for young people aged 15 years and over.
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Substance misuse has been included as a coexisting condition that should be looked for.
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A recommendation has been amended to indicate that antipsychotics should not be started in primary care unless under the supervision of a consultant psychiatrist.
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A recommendation has been amended to reflect recent terminology relating to ethnic groups and to remove reference to specific agencies.
These recommendations are marked as [2009, amended 2014].
Recommendations marked [2009] last had an evidence review in 2009. In some cases, minor changes have been made to the wording to bring the language and style up to date, without changing the meaning.
Minor updates since publication
September 2024: We added links to relevant technology appraisal guidance in the sections on assessment and care planning and interventions for people whose illness has not responded adequately to treatment.
July 2024: We have simplified the guideline by removing recommendations that are covered in other sources (such as other NICE guidelines or the BNF), and recommendations that are general good practice advice with no supporting evidence.
This is a presentational change only, and no changes to practice are intended.
November 2022: In recommendation 1.5.6.1 we removed the wording about initially using a small test dose when initiating depot/long-acting injectable antipsychotic medication, as this is no longer always appropriate. See the surveillance report for more information.
December 2021: Following a surveillance review we have updated recommendations 1.3.6.1 and 1.3.6.4 to say that either glycosylated haemoglobin (HbA1c) or fasting blood glucose may be used to test for diabetes in people taking antipsychotic medication.
August 2019: Text has been added to recommendation 1.1.2.1 to indicate that the advice has not changed after our review of the 2019 STEPWISE trial. The recommendation label has been changed to [2019] to indicate that the evidence was last reviewed in 2019. Links have been updated.
ISBN: 978-1-4731-0428-0