Barcelona snapshots

Prof. Christoph U. Correll

Christoph U. Correll psiquiatra Controversias Psiquiatría Barcelona
Hofstra University, EE.UU. & Charité-Universitätsmedizin Berlin, Alemania
Ponencia Previniendo la resistencia al tratamiento desde el comienzo
Fecha Viernes, 26 de Abril, 2019
Hora 9:00 a 9:45
Mesa redonda Resistencia al tratamiento en esquizofrenia

BIOGRAFÍA

Prof. Dr. med Christoph Correll is Chair of the Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Virchow, Berlin, Germany. Furthermore, he is Professor of Psychiatry at The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA. He completed his medical studies at the Free University of Berlin in Germany, and Dundee University Medical School in Scotland. He is board certified in general psychiatry and child and adolescent psychiatry, having completed both residencies at The Zucker Hillside Hospital in New York City. Since 1997, he has been working and conducting research in New York, USA.

Professor Correll's research and clinical work focus on the identification, characterisation and treatment of youth with severe mental illness, including psychotic and mood disorders, spanning all disease stages from the prodrome to first and multi-episode illness and up to refractory illness. He further focuses on psychopharmacology, epidemiology, comparative effectiveness, the risk–benefit evaluation of psychotropic medications and the interface between psychiatry and medicine.

He has authored or co-authored over 500 journal articles, and in October 2018 his H-index in Web of Science was 67 (Google Scholar: 86). He has served on several expert consensus panels on the use of antipsychotics across a range of psychiatric disorders, is a reviewer for over 70 peer-reviewed journals and an editorial board member of 12 scientific journals. Professor Correll has received over 40 national and international research awards and fellowships for his work.

Since 2014, the year of inception of this metric, he has been listed every year by Thomson Reuters/Web of Science as one of the “most influential scientific minds” and “top 1% cited scientists in the area of psychiatry” (https://clarivate.com/hcr/).

Additionally, he holds the following rankings:
  1. Ranked number 1 among world's experts on the topic of psychotropic drugs, out of 119,436 ranked scientists (10/2018) (http://expertscape.com/ex/psychotropic+drugs)
  2. Ranked number 1 among world's experts on the topic of schizophrenia, out of 65,021 ranked scientists (10/2018) (http://expertscape.com/ex/schizophrenia)
  3. Ranked number 1 among world's experts on the topic of antipsychotics, out of 51,439 ranked scientists (10/2018) (http://expertscape.com/ex/antipsychotic+agents)
  4. Ranked number 2 among world's experts on the topic of weight gain, out of 56,113 ranked scientists (10/2018) (http://expertscape.com/ex/weight+gain)
  5. Ranked number 6 among world's experts on the topic of clozapine, out of 8,668 ranked scientists (10/2018) (http://expertscape.com/ex/clozapine)

RESUMEN

Treatment-resistant schizophrenia (TRS) remains an all too frequent problem in the management of schizophrenia. Even 66 years after the serendipitous discovery of chlorpromazine, the only approved medication for TRS is clozapine, a medication whose mechanism of action has still not been well understood and whose adverse effects are among the most severe of all antipsychotics.

Therefore, understanding and preventing the emergence of treatment-resistance in schizophrenia is of foremost importance. Next to primary treatment resistance, which is likely due to a biologically distinct illness type not or less related to a dysfunction in the dopaminergic system, secondary treatment resistance that develops over time is a prime treatment target since it may be preventable.

The first approach to preventing primary treatment resistance would be universal prevention of schizophrenia, followed by targeted prevention of schizophrenia during the clinical high-risk state, also known as the attenuated psychosis syndrome. Simultaneously, the identification of the mechanisms underlying primary TRS would enable the development of rational and targeted primary and secondary prevention. The second approach consist of secondary prevention of TRS after the emergence of a first full schizophrenia episode. Strategies include the reduction of the duration of untreated illness, prevention of psychotic relapses, use of long-acting injectable medications early in the illness, and combination of psychopharmacologic treatments with evidence-based psychosocial interventions. Maintenance antipsychotic treatment is key for relapse prevention which can aid prevention of secondary treatment resistance. Since obesity and metabolic dysfunction have also been associated with psychotic relapses, combining effective antipsychotic treatment with minimization of cardiometabolic adverse effects and targeting of physical health are important to minimize TRS and maximize positive treatment outcomes.

This presentation will summarize pathways into TRS and highlight different opportunities for delaying, preventing or addressing TRS, which can help clinicians in their treatment planning.

REFERENCIAS

[web] Kane JM, Agid O, Baldwin ML, Howes O, Lindenmayer JP, Marder S, Olfson M, Potkin SG, Correll CU (2019). Clinical Guidance on the Identification and Management of Treatment-Resistant Schizophrenia. J Clin Psychiatry. 2019 Mar 5;80(2). pii: 18com12123. doi: 10.4088/JCP.18com12123. PubMed PMID: 30840788.

[web] Howes OD, McCutcheon R, Agid O, de Bartolomeis A, van Beveren NJ, Birnbaum ML, Bloomfield MA, Bressan RA, Buchanan RW, Carpenter WT, Castle DJ, Citrome L, Daskalakis ZJ, Davidson M, Drake RJ, Dursun S, Ebdrup BH, Elkis H, Falkai P, Fleischacker WW, Gadelha A, Gaughran F, Glenthøj BY, Graff-Guerrero A, Hallak JE, Honer WG, Kennedy J, Kinon BJ, Lawrie SM, Lee J, Leweke FM, MacCabe JH, McNabb CB, Meltzer H, Möller HJ, Nakajima S, Pantelis C, Reis Marques T, Remington G, Rossell SL, Russell BR, Siu CO, Suzuki T, Sommer IE, Taylor D, Thomas N, Üçok A, Umbricht D, Walters JT, Kane J, Correll CU (2017). Treatment-Resistant Schizophrenia: Treatment Response and Resistance in Psychosis (TRRIP) Working Group Consensus Guidelines on Diagnosis and Terminology. Am J Psychiatry. 2017 Mar 1;174(3):216-229. doi: 10.1176/appi.ajp.2016.16050503. Epub 2016 Dec 6. PubMed PMID: 27919182; PubMed Central PMCID: PMC6231547.

[web] Üçok A, Çıkrıkçılı U, Ergül C, Tabak Ö, Salaj A, Karabulut S, Correll CU (2016). Correlates of Clozapine Use after a First Episode of Schizophrenia: Results From a Long-term Prospective Study. CNS Drugs. 2016 Oct;30(10):997-1006. doi: 10.1007/s40263-016-0358-z. PubMed PMID: 27356920.

[web] Carbon M, Correll CU (2014). Clinical predictors of therapeutic response to antipsychotics in schizophrenia. Dialogues Clin Neurosci. 2014 Dec;16(4):505-24. PubMed PMID: 25733955; PubMed Central PMCID: PMC4336920.