Treatment guidelines provide evidence-based recommendations for diagnosis and treatment to assist clinicians, care givers and patients in finding an optimized treatment option in given clinical situations. Specific treatment guidelines for schizophrenia issued by the German Association of Psychiatry, Psychotherapy and Psychosomatics (DGPPN) and published under the auspices of the Working Group for Scientific Medical Specialist Societies (AWMF) (i.e. fulfilling the highest quality standards at the S3 level) have been available in Germany since 2006. Currently, a comprehensive revision process is ongoing to update these guidelines with the aim to publish the revision before 2014. However, since publication of the German treatment guidelines many clinical trials and meta-analyses have been published which appear to make a new evaluation of antipsychotic drug treatment necessary. Currently available national and international guidelines, such as the WFSBP, PORT and NICE guidelines, place less emphasis on the general superiority of atypical antipsychotic medication but support the idea to evaluate antipsychotic drugs based on the side effect profiles. The present overview discusses the recent guidelines development processes regarding schizophrenia and compares the available German treatment guidelines with recently published international guidelines. Current developments and issues for discussion are described in detail to provide possible implications for changes in treatment recommendations.