Please use this identifier to cite or link to this item:
|Title:||Defining treatment-resistant schizophrenia and response to antipsychotics : a review and recommendation|
Mulsant, Benoit H.
Rajji, Tarek K.
|Publisher:||Elsevier Ireland Ltd.|
|Citation:||Suzuki, T., Remington, G., Mulsant, B. H., Uchida, H., Rajji, T. K., Graff-Guerrero, A., ... & Mamo, D. C. (2012). Defining treatment-resistant schizophrenia and response to antipsychotics: a review and recommendation. Psychiatry Research, 197(1), 1-6.|
|Abstract:||Treatment-resistant schizophrenia (TRS) has been defined mainly by severity of (positive) symptoms and response to antipsychotics derived from a relative change in the representative scales (most frequently ≥ 20% decrease in the Positive and Negative Syndrome Scale: PANSS), but these definitions have not necessarily been consistent. Integrating past evidence and real-world practicability, we propose that TRS be defined by at least two failed adequate trials with different antipsychotics (at chlorpromazine-equivalent doses of ≥ 600 mg/day for ≥ 6 consecutive weeks) that could be retrospective or preferably include prospective failure to respond to one or more antipsychotic trials. In addition, our proposed criteria require both a score of ≥ 4 on the Clinical Global Impression (CGI)-Severity and a score of ≤ 49 on the Functional Assessment for Comprehensive Treatment of Schizophrenia (FACT-Sz) or ≤ 50 on the Global Assessment of Functioning (GAF) scales to define TRS. Once TRS is established, we propose that subsequent treatment response be defined based on a CGI-Change score of ≤ 2, a ≥ 20% decrease on the total PANSS or Brief Psychiatric Rating Scale (BPRS) scores, and an increase of ≥ 20 points on the FACT-Sz or GAF. While these suggestions provide a pragmatic framework for TRS classification, they need to be tested in future trials.|
|Appears in Collections:||Scholarly Works - FacM&SPsy|
Files in This Item:
|217.05 kB||Adobe PDF||View/Open Request a copy|
Items in OAR@UM are protected by copyright, with all rights reserved, unless otherwise indicated.