Chakrabarti S. Clozapine resistant schizophrenia: Newer avenues of management. World J Psychiatr 2021; 11(8): 429-448 [PMID: 34513606 DOI: 10.5498/wjp.v11.i8.429]
Corresponding Author of This Article
Subho Chakrabarti, MD, Professor, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India. subhochd@yahoo.com
Research Domain of This Article
Psychiatry
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatr. Aug 19, 2021; 11(8): 429-448 Published online Aug 19, 2021. doi: 10.5498/wjp.v11.i8.429
Clozapine resistant schizophrenia: Newer avenues of management
Subho Chakrabarti
Subho Chakrabarti, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
Author contributions: Chakrabarti S is the sole author of this manuscript.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Subho Chakrabarti, MD, Professor, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India. subhochd@yahoo.com
Received: February 23, 2021 Peer-review started: February 24, 2021 First decision: March 30, 2021 Revised: April 12, 2021 Accepted: July 13, 2021 Article in press: July 13, 2021 Published online: August 19, 2021
Core Tip
Core Tip: About 40%-70% of patients develop clozapine-resistant schizophrenia, which has serious health, economic, and social consequences. Research on clozapine-resistant schizophrenia has provided little support for the efficacy of psychotropics, electroconvulsive therapy, and cognitive-behavioural therapy in augmenting clozapine non-response. Therefore, newer approaches are needed including a clinical consensus about using the most effective of the currently available augmentation strategies. Augmentation with long-acting antipsychotic injections or multi-component psychosocial interventions could also be tried. Finally, the best option at present may be to prevent clozapine resistance from developing by optimizing clozapine treatment and collaborating with patients and caregivers to ensure its continuation.
