Hostname: page-component-77c89778f8-swr86 Total loading time: 0 Render date: 2024-07-16T21:20:24.706Z Has data issue: false hasContentIssue false

Defining and characterising treatment-resistant schizophrenia

Published online by Cambridge University Press:  16 April 2020

S Marder*
Affiliation:
Psychiatry Service, West Los Angeles VA Medical Center, 11301 Wilshire Boulevard, Los Angeles, California, 90073, USA
Get access

Summary

This paper argues for a broader definition of treatment refractoriness that would include patients with partial drug responses, a relatively recent onset, less dramatic symptoms and intolerance to conventional drugs. The drug trials that define their responsiveness should be carefully conducted over a prolonged period of time, but need not include high doses or supplemental medications. If the consensus conference can agree on a definition of responsiveness, it will provide important guidance to clinicians as well as researchers.

Type
Research Article
Copyright
Copyright © Elsevier, Paris 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baldessarini, RJCohen, BMTeicher, MHSignificance of neuroleptic dose and plasma level in the pharmacological treatment of psychoses. Arch Gen Psychiatry 1988; 45: 79–9010.1001/archpsyc.1988.01800250095013CrossRefGoogle ScholarPubMed
Breier, ABuchanan, RWKirkpatrick, Bet al.Effects of clozapine on positive and negative symptoms in outpatients with schizophrenia. Am J Psychiatry 1994; 151: 20–6Google ScholarPubMed
Carmen, JSBigelow, LBWyatt, RJLithium combined with neuroleptics in chronic schizophrenic and schizoaffective patients. J Clin Psychiatry 1981; 42: 124–8Google Scholar
Christison, GWKirch, DGWyatt, RJWhen symptoms persist: choosing among alternative somatic treatments for schizophrenia. Schizophr Bull 1991; 17: 217–4510.1093/schbul/17.2.217CrossRefGoogle Scholar
Growe, GACrayton, JAKlass, DBLithium in chronic schizophrenia. Am J Psychiatry 1979; 136: 454–510.1176/ajp.1979.136.4a.454CrossRefGoogle ScholarPubMed
Kane, JMHonigfeld, GSinger, JMeltzer, H and the Clozaril Collaborative Study Group. Clozapine for the treatment-resistant schizophrenic: A double-blind comparison versus chlorpromazine/benztropine. Arch Gen Psychiatry 1988; 45: 78910.1001/archpsyc.1988.01800330013001CrossRefGoogle Scholar
Keefe, RSEMohs, RCSilverman, JMet al.Characteristics of Kraepelininan schizophrenia and their relation to premorbid social functioningAngrist, BSchulz, SCThe neuroleptic nonresponsive patient: characterization and treatment Washington DC: American Psychiatric Press, 1990 3–21Google Scholar
Kinon, BJKane, JMJohns, Cet al.Treatment of neuroleptic-resistant schizophrenic relapse. Psychopharmacol Bull 1993; 29: 309–14Google ScholarPubMed
Meltzer, HYBernett, SBastani, Bet al.Effects of six months of clozapine treatment on the quality of life of chronic schizophrenic patients. Hosp Community Psychiatry 1990; 41: 892–7Google ScholarPubMed
Prien, RFCole, JOHigh dose chlorpromazine therapy in chronic schizophrenia. Arch Gen Psychiatry 1968; 18: 482–9510.1001/archpsyc.1968.01740040098013CrossRefGoogle Scholar
Quitkin, FRifkin, AKlein, DFVery high dosage vs standard dosage fluphenazine in chronic schizophrenia. Arch Gen Psychiatry 1975; 32: 1276–8110.1001/archpsyc.1975.01760280074007CrossRefGoogle Scholar
Small, JGKellams, JJMilstein, Vet al.A placebo-controled study of lithium combined with neuroleptics in chronic schizophrenic patients. Am J Psychiatry 1975; 132: 1315–7Google Scholar
Thompson, CThe use of high-dose antipsychotic medication. Br J Psychiatry 1994; 164: 448–5810.1192/bjp.164.4.448CrossRefGoogle ScholarPubMed
Van Putten, TMarder, SRMintz, JPoland, REHaloperidol plasma levels and clinical response: A therapeutic window relationship. Am J Psychiatry 1992; 149: 500–5Google ScholarPubMed
Wyatt, RJNeuroleptics and the natural course of schizophrenia. Schizophr Bull 1991; 17: 325–5110.1093/schbul/17.2.325CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.