Top 19 treatment resistant schizophrenia in 2022

Below are the best information and knowledge on the subject treatment resistant schizophrenia compiled and compiled by our own team alltopus:

Table of Contents

1. The neurobiology of treatment-resistant schizophrenia: paths to antipsychotic resistance and a roadmap for future research | Schizophrenia

Author: www.nature.com

Date Submitted: 03/22/2019 04:56 AM

Average star voting: 5 ⭐ ( 77435 reviews)

Summary: Treatment-resistant schizophrenia (TRS), the persistence of positive symptoms despite ≥2 trials of adequate dose and duration of antipsychotic medication with documented adherence, is a serious clinical problem with heterogeneous presentations. TRS can vary in its onset (at the first episode of psychosis or upon relapse), in its severity, and in the response to subsequent therapeutic interventions (i.e., clozapine, electroconvulsive therapy). The heterogeneity of TRS indicates that the underlying neurobiology of TRS may differ not only from treatment-responsive schizophrenia but also among patients with TRS. Several hypotheses have been proposed for the neurobiological mechanisms underlying TRS, including dopamine supersensitivity, hyperdopaminergic and normodopaminergic subtypes, glutamate dysregulation, inflammation and oxidative stress, and serotonin dysregulation. Research supporting these hypotheses is limited in part by variations in the criteria used to define TRS, as well as by the biological and clinical heterogeneity of TRS. Clinical trial designs for new treatments should be informed by this heterogeneity, and further clinical research is needed to more clearly understand the underlying neurobiology of TRS and to optimize treatment for patients with TRS.

Match with the search results: the persistence of symptoms despite ≥2 trials of antipsychotic medications of adequate dose and duration with documented adherence…. read more

The neurobiology of treatment-resistant schizophrenia: paths to antipsychotic resistance and a roadmap for future research | Schizophrenia

2. Treatment-resistant schizophrenia: current insights on the pharmacogenomics of antipsychotics

Author: www.ncbi.nlm.nih.gov

Date Submitted: 07/18/2020 04:07 PM

Average star voting: 4 ⭐ ( 50460 reviews)

Summary:

Match with the search results: Treatment-resistant schizophrenia (TRS) affects ~30% of people with a diagnosis of schizophrenia. … TRS is defined as nonresponse to at least ……. read more

Treatment-resistant schizophrenia: current insights on the pharmacogenomics of antipsychotics

3. Treatment-Resistant Schizophrenia: Genetic and Neuroimaging Correlates

Author: pubmed.ncbi.nlm.nih.gov

Date Submitted: 06/25/2021 06:52 PM

Average star voting: 5 ⭐ ( 96465 reviews)

Summary: Schizophrenia is a severe neuropsychiatric disorder that affects approximately 0.5–1% of the population. Response to antipsychotic therapy is highly variable, and it is not currently possible to predict those patients who will or will not respond to antipsychotic medication. Furthermore, a high percentage of patients, approximately 30%, are classified as treatment-resistant (treatment-resistant schizophrenia; TRS). TRS is defined as a nonresponse to at least two trials of antipsychotic medication of adequate dose and duration. These patients are usually treated with clozapine, the only evidence-based pharmacotherapy for TRS. However, clozapine is associated with severe adverse events. For these reasons, there is an increasing interest to identify better targets for drug development of new compounds and to establish better biomarkers for existing medications. The ability of antipsychotics to improve psychotic symptoms is dependent on their antagonist and reverse agonist activities at different neuroreceptors, and some genetic association studies of TRS have focused on different pharmacodynamic factors. Some genetic studies have shown an association between antipsychotic response or TRS and neurodevelopment candidate genes, antipsychotic mechanisms of action (such as dopaminergic, serotonergic, GABAergic, and glutamatergic) or pharmacokinetic factors (i.e., differences in the cytochrome families). Moreover, there is a growing body of literature on the structural and functional neuroimaging research into TRS. Neuroimaging studies can help to uncover the underlying neurobiological reasons for such resistance and identify resistant patients earlier. Studies examining the neuropharmacological mechanisms of antipsychotics, including clozapine, can help to improve our knowledge of their action on the central nervous system, with further implications for the discovery of biomarkers and the development of new treatments. The identification of the underlying mechanisms of TRS is a major challenge for developing personalized medicine in the psychiatric field for schizophrenia treatment. The main goal of precision medicine is to use genetic and brain-imaging information to improve the safety, effectiveness, and health outcomes of patients via more efficiently targeted risk stratification, prevention, and tailored medication and treatment management approaches. The aim of this review is to summarize the state of art of pharmacogenetic, pharmacogenomic and neuroimaging studies in TRS.

Match with the search results: Treatment resistant schizophrenia (TRS) refers to the significant proportion of schizophrenia patients who continue to have symptoms and poor outcomes ……. read more

Treatment-Resistant Schizophrenia: Genetic and Neuroimaging Correlates

4. Treatment-Resistant Schizophrenia

Author: www.psychiatrist.com

Date Submitted: 05/18/2020 10:55 PM

Average star voting: 5 ⭐ ( 10719 reviews)

Summary: Strategies for Recognizing Schizophrenia and Treating to Remission

Match with the search results: Treatment-resistant schizophrenia (TRS) occurs in approximately 30% of individuals diagnosed with schizophrenia, but identification and ……. read more

Treatment-Resistant Schizophrenia

5. Patient characteristics, burden and pharmacotherapy of treatment-resistant schizophrenia: results from a survey of 204 US psychiatrists – BMC Psychiatry

Author: www.frontiersin.org

Date Submitted: 04/17/2021 11:57 PM

Average star voting: 3 ⭐ ( 37033 reviews)

Summary: Minimal/non-response to antipsychotic treatment, and persistent positive symptoms despite treatment, are common among patients with schizophrenia. The aim of this study was to characterize a US treatment-resistant schizophrenia (TRS) population in terms of patient demographics, burden of symptoms, treatment history, and factors influencing therapeutic choice. In an online survey, 204 psychiatrists self-selected and completed three patient records: two TRS and one schizophrenia (‘non-TRS’). Respondents reported that 29.5% of their schizophrenia caseload had TRS. Selected TRS (n = 408) vs non-TRS (n = 204) patients were more likely to be unemployed (74.5% vs 45.1%, p < 0.001), hospitalized at least once (93.4% vs 74.0%, p < 0.001), and to have physical/psychiatric comorbidities including obesity (40.2% vs 23.5%, p < 0.001) and depression (38.7% vs 25.0%, p = 0.001). Psychiatric symptoms were more frequent and severe in TRS, and interfered more with social and functioning domains. Of positive symptoms, eliminating delusions and hallucinations was considered most important to improve a patient’s long-term prognosis. In TRS, clozapine monotherapy was the most common treatment (15.9%), though ranked fifth of ten options to treat TRS. Psychiatrists typically increased the antipsychotic dose or added a second antipsychotic before initiating clozapine or switching antipsychotics. Antipsychotic switches were most commonly due to lack of efficacy (TRS = 71.4% vs non-TRS = 54.3%, p < 0.001) and intolerability (34.4% vs 38.4%, p = 0.22) with the prior antipsychotic. Persistent hallucinatory behavior was the top symptom leading to treatment switches in TRS (63.9% vs 37.1%, p < 0.001). According to psychiatrists, symptoms have a greater clinical burden on patients with TRS than non-TRS. TRS is commonly managed by antipsychotic dose increases/combinations, with clozapine the fifth preference despite being the only approved TRS medication. New treatments are needed for patients who do not respond to available antipsychotics.

Match with the search results: Furthermore, a high percentage of patients, approximately 30%, are classified as treatment-resistant (treatment-resistant schizophrenia; TRS)….. read more

Patient characteristics, burden and pharmacotherapy of treatment-resistant schizophrenia: results from a survey of 204 US psychiatrists - BMC Psychiatry

6. Is treatment-resistant schizophrenia categorically distinct from treatment-responsive schizophrenia? a systematic review – BMC Psychiatry

Author: www.uptodate.com

Date Submitted: 03/13/2021 05:57 AM

Average star voting: 3 ⭐ ( 69248 reviews)

Summary: Schizophrenia is a highly heterogeneous disorder, and around a third of patients are treatment-resistant. The only evidence-based treatment for these patients is clozapine, an atypical antipsychotic with relatively weak dopamine antagonism. It is plausible that varying degrees of response to antipsychotics reflect categorically distinct illness subtypes, which would have significant implications for research and clinical practice. If these subtypes could be distinguished at illness onset, this could represent a first step towards personalised medicine in psychiatry. This systematic review investigates whether current evidence supports conceptualising treatment-resistant and treatment-responsive schizophrenoa as categorically distinct subtypes. A systematic literature search was conducted, using PubMed, EMBASE, PsycInfo, CINAHL and OpenGrey databases, to identify all studies which compared treatment-resistant schizophrenia (defined as either a lack of response to two antipsychotic trials or clozapine prescription) to treatment-responsive schizophrenia (defined as known response to non-clozapine antipsychotics). Nineteen studies of moderate quality met inclusion criteria. The most robust findings indicate that treatment-resistant patients show glutamatergic abnormalities, a lack of dopaminergic abnormalities, and significant decreases in grey matter compared to treatment-responsive patients. Treatment-resistant patients were also reported to have higher familial loading; however, no individual gene-association study reported their findings surviving correction for multiple comparisons. Tentative evidence supports conceptualising treatment-resistant schizophrenia as a categorically different illness subtype to treatment-responsive schizophrenia. However, research is limited and confirmation will require replication and rigorously controlled studies with large sample sizes and prospective study designs.

Match with the search results: Current medication and psychosocial interventions should be optimized. Treatment strategies for patients who remain incompletely responsive to ……. read more

Is treatment-resistant schizophrenia categorically distinct from treatment-responsive schizophrenia? a systematic review - BMC Psychiatry

7. Treatment-Resistant Schizophrenia: Treatment Response and Resistance in Psychosis (TRRIP) Working Group Consensus Guidelines on Diagnosis and Terminology | American Journal of Psychiatry

Author: www.psychiatrictimes.com

Date Submitted: 09/22/2019 11:31 AM

Average star voting: 3 ⭐ ( 95024 reviews)

Summary:

Match with the search results: Since the introduction of chlorpromazine, the first antipsychotic drug, it has been evident that a large number of patients have ……. read more

Treatment-Resistant Schizophrenia: Treatment Response and Resistance in Psychosis (TRRIP) Working Group Consensus Guidelines on Diagnosis and Terminology | American Journal of Psychiatry

8. Treatment-Resistant Schizophrenia | FOCUS

Author: bmcpsychiatry.biomedcentral.com

Date Submitted: 04/10/2019 12:43 PM

Average star voting: 4 ⭐ ( 81073 reviews)

Summary:

Match with the search results: Treatment-resistant schizophrenia (TRS) is broadly defined in clinical guidelines as an inadequate response in target schizophrenia symptoms ……. read more

Treatment-Resistant Schizophrenia | FOCUS

9. Immune Signatures of Treatment-Resistant Schizophrenia: A FondaMental Academic Centers of Expertise for Schizophrenia (FACE-SZ) Study

Author: bmcpsychiatry.biomedcentral.com

Date Submitted: 12/08/2019 10:54 AM

Average star voting: 4 ⭐ ( 98700 reviews)

Summary: Abstract. Treatment-resistant schizophrenia (TRS) affects around 30% of patients with schizophrenia (SZ) resulting in poor functioning, relapses, and reduced qu

Match with the search results: Schizophrenia is a highly heterogeneous disorder, and around a third of patients are treatment-resistant. The only evidence-based treatment for ……. read more

Immune Signatures of Treatment-Resistant Schizophrenia: A FondaMental Academic Centers of Expertise for Schizophrenia (FACE-SZ) Study

10. Pharmacotherapy of treatment-resistant schizophrenia: a clinical perspective

Author: ajp.psychiatryonline.org

Date Submitted: 03/19/2019 02:52 AM

Average star voting: 5 ⭐ ( 95898 reviews)

Summary:

Match with the search results: Three key elements define the concept of treatment-resistant schizophrenia: 1) a confirmed diagnosis of schizophrenia based on validated ……. read more

Pharmacotherapy of treatment-resistant schizophrenia: a clinical perspective

11. Managing patients with “treatment-resistant” schizophrenia

Author: focus.psychiatryonline.org

Date Submitted: 09/03/2021 10:06 AM

Average star voting: 5 ⭐ ( 30157 reviews)

Summary:

Match with the search results: the persistence of symptoms despite ≥2 trials of antipsychotic medications of adequate dose and duration with documented adherence…. read more

Managing patients with

12. Treatment-Resistant Schizophrenia – an overview | ScienceDirect Topics

Author: academic.oup.com

Date Submitted: 06/03/2020 05:32 AM

Average star voting: 5 ⭐ ( 29004 reviews)

Summary:

Match with the search results: Treatment-resistant schizophrenia (TRS) affects ~30% of people with a diagnosis of schizophrenia. … TRS is defined as nonresponse to at least ……. read more

Treatment-Resistant Schizophrenia - an overview | ScienceDirect Topics

13. Help for Treatment Resistant Psychosis | Here to Help

Author: ebmh.bmj.com

Date Submitted: 09/30/2020 03:03 PM

Average star voting: 5 ⭐ ( 96939 reviews)

Summary: Clozapine is a medication that can be very effective for people whose schizophrenia has not responded well to other medications. It is used to treat symptoms such as hallucinations and delusions.

Match with the search results: Treatment resistant schizophrenia (TRS) refers to the significant proportion of schizophrenia patients who continue to have symptoms and poor outcomes ……. read more

Help for Treatment Resistant Psychosis | Here to Help

14. Clozapine for the Treatment-Resistant Schizophrenic

Author: www.cambridge.org

Date Submitted: 05/24/2020 05:09 AM

Average star voting: 4 ⭐ ( 74967 reviews)

Summary: • The treatment of schizophrenic patients who fail to respond to adequate trials of neuroleptics is a major challenge. Clozapine, an atypical antipsychotic drug

Match with the search results: Treatment-resistant schizophrenia (TRS) occurs in approximately 30% of individuals diagnosed with schizophrenia, but identification and ……. read more

Clozapine for the Treatment-Resistant Schizophrenic

15. A modelling approach to estimate the prevalence of treatment-resistant schizophrenia in the United States

Author: www.mja.com.au

Date Submitted: 06/23/2021 09:57 AM

Average star voting: 4 ⭐ ( 89470 reviews)

Summary: Introduction Schizophrenia is a condition that places a significant burden on individuals with the condition, their family, and society. A large proportion of those treated for schizophrenia do not experience treatment response and are referred to as having “treatment-resistant schizophrenia” (TRS). Expert opinion has long held that the prevalence of TRS among individuals with schizophrenia is 30%, but the basis of this estimate is unclear. This article presents a model developed for estimating the prevalence of TRS in the United States 2014. Methods An incidence-prevalence-mortality model was developed to estimate the prevalence of TRS in the United States. The model was populated with data from public health agencies and published literature. Prevalence in 2014 was modelled using a Markov cohort simulation for each birth cohort between 1930 to 2014. Results Using different scenarios for baseline incidence, relative risks of mortality, it was estimated that approximately 22% of individuals with schizophrenia would be considered treatment-resistant in 2014. Discussion The results suggests that prevalence of TRS may be somewhat lower than the 30% often reported, however this is highly dependent on the definition of treatment resistance. Methods such as this may help answer epidemiological and health policy questions as well as test the influence of key underlying assumptions.

Match with the search results: Furthermore, a high percentage of patients, approximately 30%, are classified as treatment-resistant (treatment-resistant schizophrenia; TRS)….. read more

A modelling approach to estimate the prevalence of treatment-resistant schizophrenia in the United States

16. Predicting treatment resistance in schizophrenia patients

Author: www.sciencedirect.com

Date Submitted: 08/08/2019 11:35 PM

Average star voting: 3 ⭐ ( 13780 reviews)

Summary: Using statistical analyses to predict patients at risk of developing treatment-resistant schizophrenia, and help mprove their outcomes.

Match with the search results: Current medication and psychosocial interventions should be optimized. Treatment strategies for patients who remain incompletely responsive to ……. read more

Predicting treatment resistance in schizophrenia patients

17. NIHR Evidence – ‘Last resort’ antipsychotic remains the gold standard for treatment-resistant schizophrenia – Informative and accessible health and care research

Author: www.heretohelp.bc.ca

Date Submitted: 10/01/2020 05:54 PM

Average star voting: 4 ⭐ ( 49390 reviews)

Summary:

Match with the search results: Since the introduction of chlorpromazine, the first antipsychotic drug, it has been evident that a large number of patients have ……. read more

NIHR Evidence - ‘Last resort’ antipsychotic remains the gold standard for treatment-resistant schizophrenia - Informative and accessible health and care research

18. Case study: treatment-resistant schizophrenia – The Pharmaceutical Journal

Author: www.dovepress.com

Date Submitted: 08/03/2019 06:11 AM

Average star voting: 3 ⭐ ( 41448 reviews)

Summary: The Pharmaceutical Journal from the Royal Pharmaceutical Society

Match with the search results: Treatment-resistant schizophrenia (TRS) is broadly defined in clinical guidelines as an inadequate response in target schizophrenia symptoms ……. read more

Case study: treatment-resistant schizophrenia - The Pharmaceutical Journal

19. Deep brain stimulation in treatment resistant schizophrenia: A pilot randomized cross-over clinical trial

Author: jamanetwork.com

Date Submitted: 06/30/2019 11:53 PM

Average star voting: 5 ⭐ ( 40932 reviews)

Summary:

Match with the search results: Schizophrenia is a highly heterogeneous disorder, and around a third of patients are treatment-resistant. The only evidence-based treatment for ……. read more

Deep brain stimulation in treatment resistant schizophrenia: A pilot randomized cross-over clinical trial

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