Abstract
Treatment resistant schizophrenia (TRS) refers to the significant proportion of schizophrenia patients who continue to have symptoms and poor outcomes despite treatment. While many definitions of TRS include failure of two different antipsychotics as a minimum criterion, the wide variability in inclusion criteria has challenged the consistency and reproducibility of results from studies of TRS. We begin by reviewing the clinical, neuroimaging, and neurobiological characteristics of TRS. We further review the current treatment strategies available, addressing clozapine, the first-line pharmacological agent for TRS, as well as pharmacological and non-pharmacological augmentation of clozapine including medication combinations, electroconvulsive therapy, repetitive transcranial magnetic stimulation, deep brain stimulation, and psychotherapies. We conclude by highlighting the most recent consensus for defining TRS proposed by the Treatment Response and Resistance in Psychosis Working Group, and provide our overview of future perspectives and directions that could help advance the field of TRS research, including the concept of TRS as a potential subtype of schizophrenia.
Citations
May 23, 2020·Clinical and Translational Science·Noraly StamJurjen J Luykx
Jun 14, 2019·Frontiers in Pharmacology·Claudia Pisanu, Alessio Squassina
Sep 29, 2019·Evidence-based Complementary and Alternative Medicine : ECAM·Gioacchino CalapaiFabio Firenzuoli
Sep 26, 2019·Frontiers in Psychiatry·Cheryl Cheuk-Yan LeungArsime Demjaha
Nov 27, 2018·International Urology and Nephrology·Chellappan Praveen RajneeshChih-Wei Peng
Feb 15, 2019·Frontiers in Psychiatry·Bruce J Kinon
Sep 29, 2019·International Journal of Molecular Sciences·Aline HajjSouheil Hallit
Oct 4, 2020·Journal of Clinical Medicine·Laura DellazizzoAlexandre Dumais
Jul 19, 2020·NPJ Schizophrenia·Lennart KyllesøEspen Molden
Oct 2, 2020·Molecular Medicine Reports·Xu YouYong Zeng
Aug 17, 2020·Medical Hypotheses·Li-Chung HuangYen Kuang Yang
Feb 14, 2021·NPJ Schizophrenia·Laura DellazizzoAlexandre Dumais
Feb 2, 2021·CNS Spectrums·Michael A Cummings, Jennifer A O'Day
Oct 30, 2020·Scientific Reports·João V NaniMirian A F Hayashi
Nov 15, 2020·Brain Sciences·Ana Miruna DragoiSimona Trifu
Nov 5, 2020·Schizophrenia Bulletin·Joanne E PlahourasDaniel M Blumberger
Feb 19, 2021·European Eating Disorders Review : the Journal of the Eating Disorders Association·Fernando Fernández-ArandaSusana Jiménez-Murcia
Mar 17, 2020·Schizophrenia Research·Maren Caroline Frogner WernerNils Eiel Steen
Mar 4, 2021·Biomedicines·Banny Silva Barbosa CorreiaLjubica Tasic
Feb 23, 2021·Frontiers in Pharmacology·Franciele F ScaranteAlline C Campos
Apr 17, 2021·The European Journal of Neuroscience·Giedre ValiulieneArunas Germanavicius
Nov 26, 2020·Schizophrenia Research·Frederick C NuciforaPhilip D Harvey
Jul 6, 2021·Psychiatry Investigation·Sun-Young MoonJun Soo Kwon
Jul 16, 2021·Scientific Reports·Md Altaf-Ul-AminShigehiko Kanaya
Jul 26, 2021·Journal of Psychiatric Research·Marco SpangaroRoberto Cavallaro
Oct 14, 2021·Molecular Psychiatry·Kun YangAkira Sawa