National Journal of Basic Medical Sciences


Pages: 221-226DOI:

Date of Publication: 30-Nov--0001

Recent Advances in Treatment Resistant Schizophrenia - Pharmacological, Non-Pharmacological, Genetic and Neuroanatomical Aspects

Author: Anand M.S

Category: Clinical Sciences

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Schizophrenia is the most common within a spectrum of clinically similar conditions, including schizoaffective disorder, schizotypal disorder and acute and transient psychotic disorders. 1% of the population meet diagnostic criteria for the disorder over their lifetime. The aetiology is complex and multifactorial involving genetic, environmental factors, neurodevelopment insults and several neurotransmitter systems.

Treatment Resistant Schizophrenia represents severe and persistent, unremitting illness as judged by symptom, neurocognitive and disability criteria. Failure to respond to at least 2 classes of antipsychotics in optimal doses over 6-8 weeks is considered Treatment Resistant Schizophrenia.

Method : Extensive literature on TRS was reviewed using medline, cochrane and pubmed search engines. Internationally recognised evidence-based guidelines were reviewed and information synthesised.

Conclusions: Clozapine remains the gold standard treatment with its unique properties. Other non- pharmacological and psychosocial interventions are being increasingly evaluated. Despite the recent advances, management of TRS continues to be a challenge.

The author has no conflict of interest with any organisation and hopes to present an unbiased view.

Keywords: Schizophrenia, Clozapine, schizoaffective disorder