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A false case of clozapine-resistant schizophrenia
J P Maia-de-Oliveira1, J P Pinto, V Alexandre
1Department of Neuroscience and Behavioral Sciences, Ribeirao Preto Medical School, University of São Paulo (USP), Hospital das Clinicas, TerceiroAndar, AvenidaBandeirantes Campus Universitario, 3900, Ribeirao Preto, SP 14049-900, Brazil.
Abstract:
One of the subjects that most concerns physicians is treatment-resistance. About 30%-60% of schizophrenia patients do not respond adequately to antipsychotic treatment and are known as refractory schizophrenia patients. Clozapine has been the drug of choice in such cases. However, approximately 30% of them do not respond to clozapine either. Here, we describe a patient with an initial diagnosis of refractory schizophrenia who had a history of dramatic aggressiveness. However, in this case, "refractoriness" was a wrong diagnosis. A case of psychosis secondary to epilepsy had been treated as schizophrenia for almost 20 years. Reports like this one are important because they remind us of how a thorough investigation can lead to the correct diagnosis and improve the patient's prognosis.
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