Treatment Updates in Schizophrenia and Schizophrenia Spectrum Disorders
Advances in treatment are reviewed, including conceptual advances in understanding, quantifying, and targeting cognitive symptoms, which are pervasive through the lifespan, and digital therapeutics, a set of apps and wearables meant to enhance care for psychotic disorders by utilizing well-established psychotherapy treatment principles.
Abstract
Schizophrenia and other chronic psychotic disorders are notoriously difficult to treat and full remission is unfortunately not the norm. In this article, we will review advances in treatment as follows: 1) conceptual advances in understanding, quantifying, and targeting cognitive symptoms, which are pervasive through the lifespan; 2) advancements in targeting metabolic and motor effects of antipsychotic medications with vesicular monoamine transporter (VMAT) inhibitors and compounds such as samidorphan, and newer antipsychotics with varied neurotransmitter targets, including cholinergic modulation, glutamatergic tone, lesser known receptor systems such as glycine transporters, and trace amine-associated receptor 1 (TAAR1) agents; 3) enhanced delivery mechanisms leading to quarterly and biyearly long-acting injectables; and 4) digital therapeutics, a set of apps and wearables meant to enhance care for psychotic disorders by utilizing well-established psychotherapy treatment principles; packaged in smartphone applications, the interventions can be delivered in a private customized manner that bypasses access issues and supports microbehavioral experiments to target negative and cognitive symptoms. [ Psychiatr Ann . 2025;55(1):e8–e13.]