Related Experiment Video
Updated: May 21, 2026
08:20
MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder
Published on: August 11, 2015
Treatment-resistant Schizophrenia: Evidence-based Strategies
Susanne Englisch1, Mathias Zink
1Senior Resident, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health (CIMH). Mannheim, Germany.
Mens Sana Monographs
|June 2, 2012
Summary
Managing treatment-resistant schizophrenia often involves polypharmacy, but evidence supports clozapine combinations and antidepressant augmentation over mood stabilizers for better outcomes.
Area of Science:
- Psychiatry and Pharmacology
- Clinical Neuroscience
Background:
- Treatment-resistant schizophrenia presents significant challenges to functional recovery.
- Current pharmacological guidelines often recommend antipsychotic monotherapy, limiting options for complex cases.
Purpose of the Study:
- To review evidence for add-on strategies in treatment-refractory schizophrenia.
- To evaluate the efficacy of polypharmacy beyond antipsychotic monotherapy.
Main Methods:
- Systematic review of clinical trials and meta-analyses on antipsychotic polypharmacy.
- Analysis of combination therapies including clozapine, mood stabilizers, and antidepressants.
Main Results:
- Combinations of clozapine with second-generation antipsychotics and augmentation with antidepressants show promise.
- Augmentation with mood stabilizers did not demonstrate superiority over placebo.
Conclusions:
- Evidence supports specific polypharmacy strategies for treatment-resistant schizophrenia.
- Future research should explore novel agents, cognitive deficits, and cognitive behavioral therapy.
Related Concept Videos
01:26Psychosis: Goals of Pharmacotherapy
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation. For...
01:28Drug Therapy
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
01:24Treatment Strategies for Psychological Disorders
Treatment approaches for psychological disorders fall into three main categories: psychological, biological, and sociocultural. Each approach targets different aspects of mental health, requiring varying levels of education and training.
Psychological therapies focus on modifying emotions, thoughts, and behaviors through talking, interpreting, listening, rewarding, challenging, and modeling. Clinical psychologists, counselors, and social workers commonly practice psychotherapy. Clinical...
Psychological therapies focus on modifying emotions, thoughts, and behaviors through talking, interpreting, listening, rewarding, challenging, and modeling. Clinical psychologists, counselors, and social workers commonly practice psychotherapy. Clinical...
01:28Psychosis and Antipsychotic Drugs: Overview
The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic symptoms in all...
02:56Treatment Resistent Cancers
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
01:29Biological Causes of Schizophrenia
Schizophrenia, a severe psychiatric disorder, arises from a complex interplay of biological factors, including genetic predisposition, structural brain abnormalities, neurotransmitter dysregulation, and developmental irregularities. These factors collectively contribute to the onset and progression of the disorder, which typically manifests in late adolescence or early adulthood.
Genetic Factors in Schizophrenia
The genetic basis of schizophrenia is strongly supported by family and twin studies.
Genetic Factors in Schizophrenia
The genetic basis of schizophrenia is strongly supported by family and twin studies.