ReviewBMC psychiatry2014
Treatment resistant schizophrenia: a comprehensive survey of randomised controlled trials.
Review in BMC psychiatry, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 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
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Antipsychotics for schizophrenia spectrum disorders with catatonic symptoms.The Cochrane database of systematic reviews · 2022Pooled it
- Treatment of clozapine-associated weight gain: a systematic review.European journal of clinical pharmacology · 2015Pooled it
- Memantine augmentation in clozapine-refractory schizophrenia: a randomized, double-blind, placebo-controlled crossover study.Psychological medicine · 2016Trial
- Mental Health Services for Serious Mental Illness: Scoping Review of Randomised Controlled Trials.Nursing open · 2025Article
- Long-Term Health Symptoms and Sequelae Following SARS-CoV-2 Infection: An Evidence Map.International journal of environmental research and public health · 2022Review
- Korean Medication Algorithm for Schizophrenia 2019, Second Revision: Treatment of Psychotic Symptoms.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2020Article
- Dysregulation of a specific immune-related network of genes biologically defines a subset of schizophrenia.Translational psychiatry · 2019Article
- Psychiatric pharmacist's role in overcoming barriers to clozapine use and improving management.The mental health clinician · 2019Article
- Electroconvulsive therapy: 80 years old and still going strong.World journal of psychiatry · 2019Article
- Clozapine in Reducing Aggression and Violence in Forensic Populations.The Psychiatric quarterly · 2018Review
- Article
- Protein Kinase C β: a New Target Therapy to Prevent the Long-Term Atypical Antipsychotic-Induced Weight Gain.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2017Article
- Continuing clozapine treatment with lithium in schizophrenic patients with neutropenia or leukopenia: brief review of literature with case reports.Therapeutic advances in psychopharmacology · 2016Review
- Basal Exposure Therapy: A New Approach for Treatment-Resistant Patients with Severe and Composite Mental Disorders.Frontiers in psychiatry · 2016Article
- Update on the Mechanism of Action of Aripiprazole: Translational Insights into Antipsychotic Strategies Beyond Dopamine Receptor Antagonism.CNS drugs · 2015Review
- Efficacy and safety of treating patients with refractory schizophrenia with antipsychotic medication and adjunctive electroconvulsive therapy: a systematic review and meta-analysis.Shanghai archives of psychiatry · 2015Review
- Sex differences in plasma clozapine and norclozapine concentrations in clinical practice and in relation to body mass index and plasma glucose concentrations: a retrospective survey.Annals of general psychiatry · 2015Article
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 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSchizophrenia is a common serious mental health condition which has significant morbidity and financial consequences. The mainstay of treatment has been antipsychotic medication but one third of people will have a 'treatment resistant' and most disabling and costly illness. The aim of this survey was to produce a broad overview of available randomised evidence for interventions for people whose schizophrenic illness has been designated 'treatment resistant'.
methodWe searched the Cochrane Schizophrenia Group's comprehensive Trials Register, selected all relevant randomised trials and, taking care not to double count, extracted the number of people randomised within each study. Finally we sought relevant reviews on the Cochrane Library and investigated how data on this subgroup of people had been presented.
resultsWe identified 542 relevant papers based on 268 trials (Average size 64.8 SD 61.6, range 7-526, median 56 IQR 47.3, mode 60). The most studied intervention is clozapine with 82 studies (total n = 6299) comparing it against other anti-psychotic medications. Cognitive behavioural therapy (CBT), electroconvulsive therapy (ECT), or transcranial magnetic stimulation (TMS) supplementing a standard care and risperidone supplementation of clozapine has also been extensively evaluated within trials. Many approaches, however, were clearly under researched. There were only four studies investigating combinations of non-clozapine antipsychotics. Only two psychological approaches (CBT and Family Rehabilitation Training) had more than two studies. Cochrane reviews rarely presented data specific to this important clinical sub-group.
conclusionsThis survey provides a broad taxonomy of how much evaluative research has been carried out investigating interventions for people with treatment resistant schizophrenia. Over 280 trials have been undertaken but, with a few exceptions, most treatment approaches--and some in common use--have only one or two relevant but small trials. Too infrequently the leading reviews fail to highlight the paucity of evidence in this area--as these reviews are maintained this shortcoming should be addressed.
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.