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Treatment-refractory schizophrenia

MedGen UID:
1786789
•Concept ID:
C3544321
•
Mental or Behavioral Dysfunction
Synonyms: Refractory Schizophrenia; Schizophrenia, Refractory; Schizophrenia, Treatment Resistant; Schizophrenia, Treatment-Resistant; Treatment Resistant Schizophrenia; Treatment-Resistant Schizophrenia
 
Monarch Initiative: MONDO:0005414

Definition

Schizophrenia which does not respond to commonly used treatments. [from MONDO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVTreatment-refractory schizophrenia

Professional guidelines

PubMed

Clozapine v. first- and second-generation antipsychotics in treatment-refractory schizophrenia: systematic review and meta-analysis.
Siskind D, McCartney L, Goldschlager R, Kisely S
Br J Psychiatry 2016 Nov;209(5):385-392. Epub 2016 Jul 7 doi: 10.1192/bjp.bp.115.177261. PMID: 27388573
Pharmacotherapy for treatment-refractory schizophrenia.
Van Sant SP, Buckley PF
Expert Opin Pharmacother 2011 Feb;12(3):411-34. doi: 10.1517/14656566.2011.528200. PMID: 21254948
Treatment-refractory schizophrenia.
Buckley PF, Wiggins LD, Sebastian S, Singer B
Curr Psychiatry Rep 2001 Oct;3(5):393-400. doi: 10.1007/s11920-996-0033-z. PMID: 11559476

Recent clinical studies

Etiology

Schizophrenia and neurosurgery: systematic review and theories.
Dutta RR, Picton B, Brown NJ, Yang C, Lee M, Sung H, Lopez AM, Paff M
Neurosurg Focus 2023 Feb;54(2):E7. doi: 10.3171/2022.11.FOCUS22620. PMID: 36724524
Amisulpride augmentation therapy improves cognitive performance and psychopathology in clozapine-resistant treatment-refractory schizophrenia: a 12-week randomized, double-blind, placebo-controlled trial.
Zhu MH, Liu ZJ, Hu QY, Yang JY, Jin Y, Zhu N, Huang Y, Shi DH, Liu MJ, Tan HY, Zhao L, Lv QY, Yi ZH, Wu FC, Li ZZ
Mil Med Res 2022 Oct 18;9(1):59. doi: 10.1186/s40779-022-00420-0. PMID: 36253804Free PMC Article
Risk factors for clozapine-induced myocarditis and cardiomyopathy: A systematic review and meta-analysis.
Vickers M, Ramineni V, Malacova E, Eriksson L, McMahon K, Moudgil V, Scott J, Siskind D
Acta Psychiatr Scand 2022 May;145(5):442-455. Epub 2022 Feb 4 doi: 10.1111/acps.13398. PMID: 35067911
Clozapine v. first- and second-generation antipsychotics in treatment-refractory schizophrenia: systematic review and meta-analysis.
Siskind D, McCartney L, Goldschlager R, Kisely S
Br J Psychiatry 2016 Nov;209(5):385-392. Epub 2016 Jul 7 doi: 10.1192/bjp.bp.115.177261. PMID: 27388573
Treatment-refractory schizophrenia.
Buckley PF, Wiggins LD, Sebastian S, Singer B
Curr Psychiatry Rep 2001 Oct;3(5):393-400. doi: 10.1007/s11920-996-0033-z. PMID: 11559476

Diagnosis

Resistance is not futile: treatment-refractory schizophrenia - overview, evaluation and treatment.
Faden J, Citrome L
Expert Opin Pharmacother 2019 Jan;20(1):11-24. Epub 2018 Nov 8 doi: 10.1080/14656566.2018.1543409. PMID: 30407873
Elevated clozapine levels associated with infection: A systematic review.
Clark SR, Warren NS, Kim G, Jankowiak D, Schubert KO, Kisely S, Forrester T, Baune BT, Siskind DJ
Schizophr Res 2018 Feb;192:50-56. Epub 2017 Apr 6 doi: 10.1016/j.schres.2017.03.045. PMID: 28392207
When symptoms persist: clozapine augmentation strategies.
Buckley P, Miller A, Olsen J, Garver D, Miller DD, Csernansky J
Schizophr Bull 2001;27(4):615-28. doi: 10.1093/oxfordjournals.schbul.a006901. PMID: 11824488
Algorithm for treatment-refractory schizophrenia.
Koshino Y
Psychiatry Clin Neurosci 1999 Oct;53 Suppl:S9-13. PMID: 10560891
Management of treatment refractory schizophrenia.
Morrison DP
Br J Psychiatry Suppl 1996 Dec;(31):15-20. PMID: 8968651

Therapy

Amisulpride augmentation therapy improves cognitive performance and psychopathology in clozapine-resistant treatment-refractory schizophrenia: a 12-week randomized, double-blind, placebo-controlled trial.
Zhu MH, Liu ZJ, Hu QY, Yang JY, Jin Y, Zhu N, Huang Y, Shi DH, Liu MJ, Tan HY, Zhao L, Lv QY, Yi ZH, Wu FC, Li ZZ
Mil Med Res 2022 Oct 18;9(1):59. doi: 10.1186/s40779-022-00420-0. PMID: 36253804Free PMC Article
Risk factors for clozapine-induced myocarditis and cardiomyopathy: A systematic review and meta-analysis.
Vickers M, Ramineni V, Malacova E, Eriksson L, McMahon K, Moudgil V, Scott J, Siskind D
Acta Psychiatr Scand 2022 May;145(5):442-455. Epub 2022 Feb 4 doi: 10.1111/acps.13398. PMID: 35067911
Resistance is not futile: treatment-refractory schizophrenia - overview, evaluation and treatment.
Faden J, Citrome L
Expert Opin Pharmacother 2019 Jan;20(1):11-24. Epub 2018 Nov 8 doi: 10.1080/14656566.2018.1543409. PMID: 30407873
Clozapine v. first- and second-generation antipsychotics in treatment-refractory schizophrenia: systematic review and meta-analysis.
Siskind D, McCartney L, Goldschlager R, Kisely S
Br J Psychiatry 2016 Nov;209(5):385-392. Epub 2016 Jul 7 doi: 10.1192/bjp.bp.115.177261. PMID: 27388573
Pharmacotherapy for treatment-refractory schizophrenia.
Van Sant SP, Buckley PF
Expert Opin Pharmacother 2011 Feb;12(3):411-34. doi: 10.1517/14656566.2011.528200. PMID: 21254948

Prognosis

Navigated and individual α-peak-frequency-guided transcranial magnetic stimulation in male patients with treatment-refractory schizophrenia.
Tuppurainen H, Määttä S, Könönen M, Julkunen P, Kautiainen H, Hyvärinen S, Vaurio O, Joensuu M, Vanhanen M, Aho-Mustonen K, Mervaala E, Tiihonen J
J Psychiatry Neurosci 2024 Jan-Feb;49(2):E87-E95. Epub 2024 Mar 1 doi: 10.1503/jpn.230063. PMID: 38428970Free PMC Article
Optimising plasma clozapine levels to improve treatment response: an individual patient data meta-analysis and receiver operating characteristic curve analysis.
Northwood K, Pearson E, Arnautovska U, Kisely S, Pawar M, Sharma M, Vitangcol K, Wagner E, Warren N, Siskind D
Br J Psychiatry 2023 Jun;222(6):241-245. doi: 10.1192/bjp.2023.27. PMID: 36994656Free PMC Article
Clozapine v. first- and second-generation antipsychotics in treatment-refractory schizophrenia: systematic review and meta-analysis.
Siskind D, McCartney L, Goldschlager R, Kisely S
Br J Psychiatry 2016 Nov;209(5):385-392. Epub 2016 Jul 7 doi: 10.1192/bjp.bp.115.177261. PMID: 27388573
Gene polymorphisms potentially related to the pharmacokinetics of clozapine: a systematic review.
Krivoy A, Gaughran F, Weizman A, Breen G, MacCabe JH
Int Clin Psychopharmacol 2016 Jul;31(4):179-84. doi: 10.1097/YIC.0000000000000065. PMID: 25563806
Treatment-resistant schizophrenia and staff rejection.
Heresco-Levy U, Ermilov M, Giltsinsky B, Lichtenstein M, Blander D
Schizophr Bull 1999;25(3):457-65. doi: 10.1093/oxfordjournals.schbul.a033393. PMID: 10478781

Clinical prediction guides

Navigated and individual α-peak-frequency-guided transcranial magnetic stimulation in male patients with treatment-refractory schizophrenia.
Tuppurainen H, Määttä S, Könönen M, Julkunen P, Kautiainen H, Hyvärinen S, Vaurio O, Joensuu M, Vanhanen M, Aho-Mustonen K, Mervaala E, Tiihonen J
J Psychiatry Neurosci 2024 Jan-Feb;49(2):E87-E95. Epub 2024 Mar 1 doi: 10.1503/jpn.230063. PMID: 38428970Free PMC Article
Schizophrenia and neurosurgery: systematic review and theories.
Dutta RR, Picton B, Brown NJ, Yang C, Lee M, Sung H, Lopez AM, Paff M
Neurosurg Focus 2023 Feb;54(2):E7. doi: 10.3171/2022.11.FOCUS22620. PMID: 36724524
Amisulpride augmentation therapy improves cognitive performance and psychopathology in clozapine-resistant treatment-refractory schizophrenia: a 12-week randomized, double-blind, placebo-controlled trial.
Zhu MH, Liu ZJ, Hu QY, Yang JY, Jin Y, Zhu N, Huang Y, Shi DH, Liu MJ, Tan HY, Zhao L, Lv QY, Yi ZH, Wu FC, Li ZZ
Mil Med Res 2022 Oct 18;9(1):59. doi: 10.1186/s40779-022-00420-0. PMID: 36253804Free PMC Article
Clozapine v. first- and second-generation antipsychotics in treatment-refractory schizophrenia: systematic review and meta-analysis.
Siskind D, McCartney L, Goldschlager R, Kisely S
Br J Psychiatry 2016 Nov;209(5):385-392. Epub 2016 Jul 7 doi: 10.1192/bjp.bp.115.177261. PMID: 27388573
Gene polymorphisms potentially related to the pharmacokinetics of clozapine: a systematic review.
Krivoy A, Gaughran F, Weizman A, Breen G, MacCabe JH
Int Clin Psychopharmacol 2016 Jul;31(4):179-84. doi: 10.1097/YIC.0000000000000065. PMID: 25563806

Recent systematic reviews

Schizophrenia and neurosurgery: systematic review and theories.
Dutta RR, Picton B, Brown NJ, Yang C, Lee M, Sung H, Lopez AM, Paff M
Neurosurg Focus 2023 Feb;54(2):E7. doi: 10.3171/2022.11.FOCUS22620. PMID: 36724524
CBTp for people with treatment refractory schizophrenia on clozapine: a systematic review and meta-analysis.
Todorovic A, Lal S, Dark F, De Monte V, Kisely S, Siskind D
J Ment Health 2023 Feb;32(1):321-328. Epub 2020 Oct 19 doi: 10.1080/09638237.2020.1836558. PMID: 33076721
Risk factors for clozapine-induced myocarditis and cardiomyopathy: A systematic review and meta-analysis.
Vickers M, Ramineni V, Malacova E, Eriksson L, McMahon K, Moudgil V, Scott J, Siskind D
Acta Psychiatr Scand 2022 May;145(5):442-455. Epub 2022 Feb 4 doi: 10.1111/acps.13398. PMID: 35067911
Augmentation strategies for clozapine refractory schizophrenia: A systematic review and meta-analysis.
Siskind DJ, Lee M, Ravindran A, Zhang Q, Ma E, Motamarri B, Kisely S
Aust N Z J Psychiatry 2018 Aug;52(8):751-767. Epub 2018 May 6 doi: 10.1177/0004867418772351. PMID: 29732913
Clozapine v. first- and second-generation antipsychotics in treatment-refractory schizophrenia: systematic review and meta-analysis.
Siskind D, McCartney L, Goldschlager R, Kisely S
Br J Psychiatry 2016 Nov;209(5):385-392. Epub 2016 Jul 7 doi: 10.1192/bjp.bp.115.177261. PMID: 27388573

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