TREATMENT-RESISTANT SCHIZOPHRENIA - CLINICAL-EXPERIENCE WITH NEW ANTIPSYCHOTICS

Approximately 20-30% of patients with schizophrenia are resistant to c onventional neuroleptics (i.e. are treatment-resistant). Clozapine has been shown to be effective in a proportion of treatment-resistant cas es and to have a low side effect profile. However, it can cause agranu locytosis, is sedative and has marked anticholinergic properties. Risp eridone, which is effective in chronic schizophrenia and has a low sid e effect profile and does not require routine blood monitoring, was co mpared with clozapine in a double-blind comparative study in 86 treatm ent-resistant patients. Preliminary findings indicate that, at endpoin t, risperidone and clozapine were almost equieffective (total PANSS, P ANSS subscales and CGI). Both drugs caused few adverse effects, and th e severity of extrapyramidal symptoms was no different in the two grou ps. It is concluded that risperidone could be another drug effective i n treatment-resistant schizophrenia. Further, larger trials will be ne eded to confirm this.