Evidence map›Paper›PMID 30170114›Full record

ReviewNeurobiology of disease2019

Treatment resistant schizophrenia: Clinical, biological, and therapeutic perspectives.

Frederick C Nucifora, Edgar Woznica, Brian J Lee, Nicola Cascella, Akira Sawa

2 registry-linked trialsOpen access · greenAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Neurobiology of disease, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 153 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
153citing papers in PubMed, 5 pooled it
8.7field-weighted citation impact, top 2% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT06749444 narecruitingnot on this mapstarted 2024, after this paper: background citation

Cognitive Behavioral Therapy for Sleep and Circadian Disturbances (CBT-I) in Treatment-Resistant Schizophrenia

TypeinterventionalSponsorJimmi NielsenRan2024 to 2027Enrolled60ConditionsTreatment-refractory Schizophrenia, Treatment-resistant SchizophreniaArmsCBT-I, CBT
NCT07408934 naenrolling by invitationnot on this mapstarted 2024, after this paper: background citation

A Randomized Controlled Trial of Group Cognitive Behavioral Therapy (the Feeling Safe Programme) for Psychosis

TypeinterventionalSponsorThe Royal Ottawa Mental Health CentreRan2024 to 2027Enrolled50ConditionsSchizophrenia and Schizoaffective DisorderArmsCognitive Behavioral Therapy for Psychosis
3 · Its place in the literature

Who cites it

153 citing papers in PubMed, 5 syntheses or guidelines pooled it, 276 citations in OpenAlex.

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  18. Clozapine-induced Myocarditis in Korea: Analysis of a Nationwide Database and Comparison to Other Countries.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2026
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93 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Frederick C NuciforaDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21287, USA. Electronic address: nucifora@jhmi.edu.
Edgar WoznicaDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21287, USA.
Brian J LeeDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21287, USA.
Nicola CascellaDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21287, USA.
Akira SawaDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins Hospital, 600 N. Wolfe St., Baltimore, MD 21287, USA.
Johns Hopkins Hospital · US

Funding

Project 3P50MH094268 · NIMH · JOHNS HOPKINS UNIVERSITY · PI SAWA, AKIRA · 2011 to 2020
$19.9M
NIMH NIH HHS P50 MH094268
6 · The paper itself

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.

Indexed as

Drug ResistanceHumansSchizophreniaBrain ImagingCBTClozapineDBSDopamineECTGeneticsGlutamateNeurobiologyrTMSSchizophreniaTreatment-Resistant

Identifiers

PMID30170114
PMCPMC6395548
OpenAlexW2889058327

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.