Treatment-resistant schizophrenia: What can we do about it?
Use pharmacotherapy and other interventions to target the symptoms that matter most to your patient
Clozapine remains the medication of choice for treatment-resistant schizophrenia. Despite dozens of RCTs of potential adjunctive agents for treatment-resistant schizophrenia, no single approach has consistently shown efficacy in reducing symptoms, improving cognition, or increasing a patient’s level of function. Individual response can vary, and our search for the “outlier” who does respond to an adjunctive agent can explain our use of these strategies in clinical practice.
Related Resources
- Cochrane Database of Systematic Reviews. www.cochrane.org/reviews. This database contains reviews of additional therapeutic options for patients with treatment-resistant schizophrenia. As of February 23, 2011, 157 reviews were available.
- Citrome L. Treatment-refractory schizophrenia: What it is and what’s been done about it. Neuropsychiatry. 2011. Epub ahead of print.
- Citrome L. Clozapine for schizophrenia. Life-threatening or life-saving treatment? Current Psychiatry. 2009;8(12):56-63.
Drug Brand Names
- Aripiprazole • Abilify
- Armodafinil • Nuvigil
- Atomoxetine • Strattera
- Benztropine mesylate • Cogentin
- Carbamazepine • Tegretol
- Celecoxib • Celebrex
- Chlorpromazine • Thorazine
- Clozapine • Clozaril
- Fluoxetine • Prozac
- Guanfacine • Tenex
- Haloperidol • Haldol
- Lamotrigine • Lamictal
- Lithium • Eskalith, Lithobid, others
- Lurasidone • Latuda
- Methylphenidate • Ritalin, Methylin, others
- Modafinil • Provigil
- Olanzapine • Zyprexa
- Quetiapine • Seroquel
- Rifampin • Rifadin
- Risperidone • Risperdal
- Trazodone • Desyrel, Oleptro
- Valproate (Divalproex) • Depakote, Depakote ER
- Ziprasidone • Geodon
Disclosure
No writing assistance or external financial support was used for this article. Dr. Citrome is a consultant for, has received honoraria from, or has conducted clinical research supported by Abbott Laboratories, AstraZeneca Pharmaceuticals, Avanir Pharmaceuticals, Azur Pharma Inc., Barr Laboratories, Bristol-Myers Squibb, Eli Lilly and Company, Forest Research Institute, GlaxoSmithKline, Janssen Pharmaceuticals, Jazz Pharmaceuticals, Merck, Novartis, Pfizer Inc., Sunovion, Valeant Pharmaceuticals, and Vanda Pharmaceuticals.
