Psychotic disorders
Classifying psychosis, excluding the medical and drug causes, choosing and monitoring antipsychotics, clozapine and its dangers, NMS, and the physical health of people with schizophrenia.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Psychosis means delusions, hallucinations, disorganised thinking or grossly disorganised behaviour. It is a syndrome with a long list of causes, not a diagnosis.
- On a medical ward, think first of delirium, drugs (prescribed and illicit) and neurological disease.
- Start antipsychotics low, choose by adverse effects, review at 1 week and titrate, and switch only after at least 4 weeks at an adequate dose with confirmed adherence. Clozapine is the only drug proven in treatment-resistant schizophrenia.
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Sources
- INTEGRATE: international guidelines for the algorithmic treatment of schizophrenia (McCutcheon RA, Pillinger T et al. Lancet Psychiatry 2025)Lancet Psychiatry; listed as a supported best practice resource by RANZCP, 2025
- Therapeutic Guidelines: Psychotropic (February 2025 update: cariprazine, 6-monthly paliperidone palmitate)AU/NZTherapeutic Guidelines Limited, 2025
- Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders (Galletly C et al. 2016), now archived by RANZCPAU/NZRANZCP (Australian and New Zealand Journal of Psychiatry 2016;50:410-72), 2016
- Psychosis and schizophrenia in adults: prevention and management (CG178)National Institute for Health and Care Excellence, 2014
- Ronaldson KJ et al. A new monitoring protocol for clozapine-induced myocarditis based on an analysis of 75 cases and 94 controls. Aust N Z J Psychiatry 2011;45:458-65AU/NZAustralian and New Zealand Journal of Psychiatry, 2011
- Assessing Fitness to Drive: psychiatric conditionsAU/NZAustroads and National Transport Commission, 2022
- Equally Well Consensus Statement: improving the physical health and wellbeing of people living with mental illness in AustraliaAU/NZNational Mental Health Commission, 2016
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy