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Psychiatria Danubina, Vol. 33 No. suppl 4, 2021.

Conference paper

TREATMENT OF RESISTANT AND ULTRA RESISTANT SCHIZOPHRENIA

Antonija Medić ; Institute of Emergency Medicine of Zagreb County, Croatia
Dora Herceg ; School of Medicine, University of Zagreb, Croatia
Miroslav Herceg ; School of Medicine, University of Zagreb, Croatia; University Psychiatric Hospital Vrapče, Zagreb, Croatia

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Abstract

Schizophrenia is a psychiatric disease which affects one percent of population. It is most common in young adults. It is primarily
treated with typical and atypical antipsychotics. Resistant schizophrenia is a condition diagnosed after no response is noticed to two
different antipsychotics of which one is atypical. The treatment has to be undertaken with adequate doses and duration of therapy.
Clozapine is the golden standard in the treatment of therapy-resistant schizophrenia. It has shown its superiority among other
antipsychotics in various studies. Aside from greater effectiveness, advantages include absence of extrapyramidal side effects.
During clozapine treatment, regular blood tests should be performed as a screening method for agranulocytosis. Twenty to thirty
percent od schizophrenia patients suffer from treatment resistant schizophrenia. Sixty percent of the latter ones show no therapeutic
response to clozapine. In conclusion twelve to eighteen percent of all patients suffering from schizophrenia show no response to any
form of treatment. Attempts to augment clozapine effectiveness are being made by increasing the dose of monotherapy, using
antipsychotic polipharmacy or adding other types of drugs to clozapine. Unfortunately, these augmentation methods have not yet
proven themselves to be effective enough to be added to standard therapy algorythms. On the other hand, electroconvulsive therapy
is neuromodulatory method that shows promise in increasing therapeutic success. Although many methods of treatment are being
researched, therapy-resistant schizophrenia remains a clinical challenge which affects a significant percentage of population and
will require additional research.

Keywords

clozapine; electroconvulsive therapy; resistance schizophrenia; treatment

Hrčak ID:

274985

URI

https://hrcak.srce.hr/274985

Publication date:

19.10.2021.

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