Book contents
- Management of Complex Treatment-Resistant Psychotic Disorders
- Management of Complex Treatment-Resistant Psychotic Disorders
- Copyright page
- Contents
- Contributors
- Acknowledgements
- Abbreviations
- List of Icons
- Introduction
- Part I Treatment Strategies
- 1.01 Approaches to Positive Psychotic Symptoms
- 1.02 Use of Plasma Levels in Antipsychotic and Mood Stabilizer Treatment
- 1.03 Advantages of Long-Acting Injectable Antipsychotics
- 1.04 Approach to Treatment-Resistant Schizophrenia Spectrum Patients
- 1.05 Approach to Depressed or Suicidal Schizophrenia Spectrum Patients
- 1.06 Approach to Persistent Aggression and Violence in Schizophrenia Spectrum Psychotic Disorders
- 1.07 Approach to Bipolar Diathesis in Schizophrenia Spectrum Patients
- 1.08 Approach to Anxiety in Schizophrenia Spectrum Patients
- 1.09 Approach to Insomnia and Sleep Disturbance in Schizophrenia Spectrum Disorders
- 1.10 Approach to Psychosis in Children and Adolescents
- 1.11 Electroconvulsive Therapy and Other Non-Pharmacological Treatments
- 1.12 Approach to Substance Use Disorders in Schizophrenia Spectrum Disorders
- 1.13 Approaches to Behavioral Disturbances in Dementia and Traumatic Brain Injury Patients
- Part II Medication Reference Tables
- Appendices
- Index
- References
1.04 - Approach to Treatment-Resistant Schizophrenia Spectrum Patients
from Part I - Treatment Strategies
Published online by Cambridge University Press: 19 October 2021
Book contents
- Management of Complex Treatment-Resistant Psychotic Disorders
- Management of Complex Treatment-Resistant Psychotic Disorders
- Copyright page
- Contents
- Contributors
- Acknowledgements
- Abbreviations
- List of Icons
- Introduction
- Part I Treatment Strategies
- 1.01 Approaches to Positive Psychotic Symptoms
- 1.02 Use of Plasma Levels in Antipsychotic and Mood Stabilizer Treatment
- 1.03 Advantages of Long-Acting Injectable Antipsychotics
- 1.04 Approach to Treatment-Resistant Schizophrenia Spectrum Patients
- 1.05 Approach to Depressed or Suicidal Schizophrenia Spectrum Patients
- 1.06 Approach to Persistent Aggression and Violence in Schizophrenia Spectrum Psychotic Disorders
- 1.07 Approach to Bipolar Diathesis in Schizophrenia Spectrum Patients
- 1.08 Approach to Anxiety in Schizophrenia Spectrum Patients
- 1.09 Approach to Insomnia and Sleep Disturbance in Schizophrenia Spectrum Disorders
- 1.10 Approach to Psychosis in Children and Adolescents
- 1.11 Electroconvulsive Therapy and Other Non-Pharmacological Treatments
- 1.12 Approach to Substance Use Disorders in Schizophrenia Spectrum Disorders
- 1.13 Approaches to Behavioral Disturbances in Dementia and Traumatic Brain Injury Patients
- Part II Medication Reference Tables
- Appendices
- Index
- References
Summary
Inadequate treatment contributes not only to poor quality of life but also to an increase in disease-related societal burdens. A small subset (20–30%) of the schizophrenia patient population are treatment-resistant and financially cost approximately ten-fold more than non-treatment-resistant schizophrenia patients [1]. Numerous ineffective antipsychotic trials continue to be prescribed while clozapine, which has widespread compelling efficacy data, continues to be underutilized in treatment-resistant schizophrenia. This chapter addresses clozapine efficacy in not only treatment-resistant psychosis but also comorbid suicidality and aggression, as well as treatment-resistant mania. Further, initiation and maintenance of clozapine treatment is summarized.
- Type
- Chapter
- Information
- Publisher: Cambridge University PressPrint publication year: 2021
References
Meyer, J. M. (2019). The Clozapine Handbook. Stahl’s Handbooks. New York: Cambridge University Press.CrossRefGoogle Scholar
Kane, J., Honigfeld, G., Singer, J., et al. (1988). Clozapine for the treatment-resistant schizophrenic: a double-blind comparison with chlorpromazine. Arch Gen Psychiatry, 45, 789–796.CrossRefGoogle ScholarPubMed
Howes, O. D., McCutcheon, R., Agid, O., et al. (2016). Treatment-resistant schizophrenia: treatment response and resistance in psychosis (TRRIP) working group consensus guidelines on diagnosis and terminology. Am J Psychiatry, 174, 216–229.CrossRefGoogle Scholar
Galling, B., Roldan, A., Hagi, K., et al. (2017). Antipsychotic augmentation vs. monotherapy in schizophrenia: systematic review, meta-analysis and meta-regression analysis. World Psychiatry, 16, 77–89.CrossRefGoogle ScholarPubMed
Stroup, T. S., Gerhard, T., Crystal, S., et al. (2015). Comparative effectiveness of clozapine and standard antipsychotic treatment in adults with schizophrenia. Am J Psychiatry, 173, 166–173.CrossRefGoogle ScholarPubMed
Siskind, D., Siskind, V., Kisely, S. (2017). Clozapine Response Rates among People with Treatment-resistant Schizophrenia: Data from a Systematic Review and Meta-analysis. Los Angeles, CA: SAGE Publications.Google ScholarPubMed
Yoshimura, B., Yada, Y., So, R., et al. (2017). The critical treatment window of clozapine in treatment-resistant schizophrenia: secondary analysis of an observational study. Psychiatry Res, 250, 65–70.CrossRefGoogle ScholarPubMed
Meltzer, H. Y., Alphs, L., Green, A. I., et al. (2003). Clozapine treatment for suicidality in schizophrenia: international suicide prevention trial (InterSePT). Arch Gen Psychiatry, 60, 82–91.CrossRefGoogle ScholarPubMed
Quanbeck, C. D., McDermott, B. E., Lam, J., et al. (2007). Categorization of aggressive acts committed by chronically assaultive state hospital patients. Psychiatr Serv, 58, 521–528.CrossRefGoogle ScholarPubMed
Meyer, J. M., Cummings, M. A., Proctor, G., et al. (2016). Psychopharmacology of persistent violence and aggression. Psychiatr Clin North Am, 39, 541–556.CrossRefGoogle ScholarPubMed
Fazel, S., Gulati, G., Linsell, L., et al. (2009). Schizophrenia and violence: systematic review and meta-analysis. PLoS Med, 6, e1000120.CrossRefGoogle ScholarPubMed
Fazel, S., Långström, N., Hjern, A., et al. (2009). Schizophrenia, substance abuse, and violent crime. JAMA, 301, 2016–2023.CrossRefGoogle ScholarPubMed
Krakowski, M. I., Czobor, P., Citrome, L., et al. (2006). Atypical antipsychotic agents in the treatment of violent patients with schizophrenia and schizoaffective disorder. Arch Gen Psychiatry, 63, 622–629.CrossRefGoogle ScholarPubMed
Frogley, C., Taylor, D., Dickens, G., et al. (2012). A systematic review of the evidence of clozapine’s anti-aggressive effects. Int J Neuropsychopharmacol, 15, 1351–1371.CrossRefGoogle ScholarPubMed
Vanderwaal, F. M. (2015). Impact of motivational interviewing on medication adherence in schizophrenia. Issues Ment Health Nurs, 36, 900–904.CrossRefGoogle ScholarPubMed
Reimer, J., Kuhn, J., Wietfeld, R., et al. (2019). Motivational interviewing: a possibility for doctor-patient communication in schizophrenia? Der Nervenarzt, 90(11), 1144–1153.CrossRefGoogle ScholarPubMed