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Treatment resistant schizophrenia: Course of brain structure and function
Philip D Harvey1, Jennifer B Rosenthal2
1University of Miami Miller School of Medicine, United States; Research Service, Bruce W. Carter VA Medical Center, Miami, FL, United States.
Summary
Treatment resistant schizophrenia (TRS) affects 30% of patients, causing continuous psychosis and brain changes. Clozapine shows promise in treating TRS and may help slow cortical deterioration.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Schizophrenia affects 30% of individuals with minimal response to standard antipsychotics, termed treatment resistant schizophrenia (TRS).
- Continuous psychosis in TRS leads to neurobiological changes, including cortical atrophy and ventricular enlargement.
- Clozapine is an effective treatment for at least one-third of patients with TRS.
Purpose of the Study:
- To review the clinical course of treatment resistant schizophrenia.
- To examine neurobiological changes in brain structure and function associated with psychosis.
- To evaluate the potential of clozapine in mitigating cortical deterioration in TRS patients.
Main Methods:
- Literature review of studies on treatment resistant schizophrenia.
- Analysis of neuroimaging data on brain structure and function in psychosis.
- Examination of evidence for clozapine's effects on cortical changes.
Main Results:
- Treatment resistant schizophrenia is associated with significant neurobiological consequences.
- Clozapine demonstrates efficacy in a subset of TRS patients.
- Evidence suggests clozapine may play a role in altering cortical deterioration.
Conclusions:
- Treatment resistant schizophrenia presents unique challenges and neurobiological impacts.
- Clozapine remains a vital therapeutic option for managing TRS.
- Further research is needed to fully understand clozapine's neuroprotective effects in TRS.
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