By Leslie Citrome

Handbook of Treatment-resistant Schizophrenia is a concise assessment of treatment-resistant schizophrenia’s definition, dimension instruments, adherence concerns, substance abuse, optimum dosing, clinician–patient relationships, and present administration techniques. The publication was once initially commissioned with the purpose of making a entire textual content targeting treatment-resistant schizophrenia and its administration. The booklet explores many points of the history and perform- and research-based facts for treating this advanced subset of schizophrenia, together with psychopharmacological, somatic, and nonpharmacological therapy methods. whereas exploring a number of the treatments for treatment-resistant schizophrenia, Dr Citrome additionally emphasizes the significance of establishing robust and trusting relationships among sufferers and their clinicians so the clinician can top deal with their patient’s adherence and total treatment.

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4 2 6 & 3 " % & 3 0 ' 5 3 & "5 . & / 5ű 3 & 4 * 4 5" / $ & t  responding adequately to an oral medication is unlikely to then respond to its depot formulation unless they were a nonresponder because of nonadherence. Potential advantages of depot antipsychotic formulations include the reduction of plasma level deviations [26] and elimination of guesswork about adherence status, thus helping to disentangle reasons for poor response to medication [27]. Depot formulations can help eliminate the abrupt loss of efficacy that can occur if oral doses are missed [26,27].

Adjunctive antidepressant use is also common among patients being treated for schizophrenia [84], although they are less widely used in Asia compared to Western countries [85]. Antidepressants may be helpful in reducing depressive symptoms as well as negative symptoms in patients with schizophrenia; both depressive symptoms and negative symptoms are common and readily assessed, and reflect that schizophrenia is a complex multidimensional disorder [86,87]. About 40 randomized controlled trials have tested adjunctive antidepressants in patients with chronic schizophrenia for ongoing depressive symptoms and/or negative symptoms; the agents studied included tricyclic and tetracyclic antidepressants, serotonin-specific reuptake inhibitors, monoamine oxidase inhibitors, mirtazapine, reboxetine, ritanserin, and trazodone [1].

1 Randomized controlled trials of antipsychotic monotherapy in treatment-refractory schizophrenia (continues opposite). 1 4 :$ ) 0 1 ) " 3 . 1 Randomized controlled trials of antipsychotic monotherapy in treatment-refractory schizophrenia (continued). All studies enrolled adults unless otherwise noted. *In some studies, multiple different outcomes were measured and some small differences may have emerged that are different from the overall results as noted here. ~, similar to or no difference from.

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