ReviewEvidence-based mental health2014
Pharmacotherapy of treatment-resistant schizophrenia: a clinical perspective.
Review in Evidence-based mental health, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 4 syntheses or guidelines pooled it, 106 citations in OpenAlex.
- Insulin effects on core neurotransmitter pathways involved in schizophrenia neurobiology: a meta-analysis of preclinical studies. Implications for the treatment.Molecular psychiatry · 2023Pooled it
- Increasing antipsychotic dose versus switching antipsychotic for non response in schizophrenia.The Cochrane database of systematic reviews · 2018Pooled it
- Guidelines for the Pharmacotherapy of Schizophrenia in Adults.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2017Pooled it
- Clozapine combined with different antipsychotic drugs for treatment-resistant schizophrenia.The Cochrane database of systematic reviews · 2017Pooled it
- Lurasidone Improves Psychopathology and Cognition in Treatment-Resistant Schizophrenia.Journal of clinical psychopharmacologyTrial
- Translating Pharmacokinetics and Pharmacodynamics into Clinical Decision-Making: A Practical Guide to the Use of Risperidone ISMJournal of clinical medicine · 2026Review
- Lurasidone vs. Other Antipsychotics as Augmentation Strategies for Clozapine in Treatment-resistant Schizophrenia: An Observational Multicenter Prospective Study.Current neuropharmacology · 2026Observational
- Comparative Study of the Efficacy and Side Effects of Brand-Name and Generic Clozapine for Long-Term Maintenance Treatment Among Korean Patients With Schizophrenia: A Retrospective Naturalistic Mirror-Image Study.Psychiatry investigation · 2024Article
- Clozapine in Treatment-Resistant Schizophrenia and Its Augmentation with Electroconvulsive Therapy in Ultra-Treatment-Resistant Schizophrenia.Biomedicines · 2023Article
- Iranian psychiatrists' attitude towards clozapine use for patients with treatment-resistant schizophrenia: a nationwide survey.BMC psychiatry · 2022Article
- Typical antipsychotics is associated with increased risk of severe exacerbation in asthma patients: a nationwide population-based cohort study.BMC pulmonary medicine · 2022Article
- Treatment-resistant schizophrenia: How far have we traveled?Frontiers in psychiatry · 2022Article
- Clozapine modulates retinoid homeostasis in human brain and normalizes serum retinoic acid deficit in patients with schizophrenia.Molecular psychiatry · 2021Article
- Cost effectiveness of pharmacogenetic-guided clozapine administration based on risk of HLA variants in Japan and the UK.Translational psychiatry · 2021Article
- Effectiveness of antipsychotic drugs in schizophrenia: a 10-year retrospective study in a Korean tertiary hospital.NPJ schizophrenia · 2020Article
- Real-world effectiveness of admissions to a tertiary treatment-resistant psychosis service: 2-year mirror-image study.BJPsych open · 2020Article
- Relegating Psychosis: Blood Work and "Routine Connection" in the Clozapine Clinic.Culture, medicine and psychiatry · 2020Article
- The neurobiology of treatment-resistant schizophrenia: paths to antipsychotic resistance and a roadmap for future research.NPJ schizophrenia · 2020Review
- Power to the voice hearer - The German version of the voice power differential scale.PloS one · 2020Article
- Clozapine augmentation strategies.The mental health clinician · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A significant number of patients with schizophrenia do not respond adequately to an initial antipsychotic trial. As first step within a treatment algorithm for therapy-refractory schizophrenia 'pseudoresistance' should be ruled out (eg, re-evaluation of the diagnosis, comorbidities, compliance and adherence in terms of medication intake, adequate dose and treatment duration, and achievement of sufficient plasma levels). In case of treatment resistance, two strategies that are often used in clinical routine care contain dose increase of the current administered antipsychotic drug (dose escalation, high-dose treatment) and switch to another, new antipsychotic. Although the response rates for both options are generally rather low, we see from the evidence-based perspective a slight advantage of the switching strategy (preferably to an antipsychotic with a different receptor-binding profile) compared to a high-dose treatment. After treatment failures with at least two different antipsychotic drugs, a monotherapy with clozapine is considered to be the treatment option of first choice. At present, pharmacological combination and augmentation strategies cannot be regarded as a generally recommendable evidence-based treatment method. Antipsychotic monotherapy should be preferably sought. In case of combination treatment, it appears more appropriate to combine preferentially two antipsychotics with different receptor-binding profiles. Augmentation of antipsychotics with other agents should be used primarily to treat specific target symptoms.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.