Management of treatment resistant schizophrenia

Abstract

Whilst gains have been made in recent years in the pharmacological treatment of schizophrenia, a number of patients still have residual symptoms and disabilities, or simply do not show response to antipsychotic medications. For such 'treatment resistant' patients, there is little by way of randomised controlled data to support any particular type of further intervention, but combinations of agents (combined antipsychotics, augmentation with mood stabilisers, antidepressants, and other agents)can show benefit in certain patients in certain domains of symptomatology and psychosocial functioning. Certain psychological and psychosocial treatment strategies can also be of benefit in this regard. This article selectively reviews the literature treatment resistance in schizophrenia, and emphasises the importance of an holistic approach to individual patients.

Keywords: schizophrenia, treatment resistance, antipsychotics, augmentation, psychosocial treatments

South African Psychiatry Review Vol. 9(1) 2006: 17-23