Evidence-Based Reviews

Treatment-resistant schizophrenia: What can we do about it?

Current Psychiatry. 2011 June;10(6):52-63

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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.