DEFINITION OF THERAPY-RESISTANT SCHIZOPHRENIA AND ITS ASSESSMENT

The treatment of nonresponsive schizophrenia poses perennial problems. The situation is made yet more complex when the great variety of pati ent types, their social background, family circumstances and psychosoc ial requirements are taken into account. The comparative lack of respo nse to neuroleptic therapy seen in some patients, especially those wit h minimal structural brain changes, further complicates the problem, p rovoking - as such therapy may - more EPS than are normally seen in pa tients without more obvious physical changes in brain structure. Until recently, the treatment of nonresponsive schizophrenia has tended to involve switching from one neuroleptic (usually a ''highpotent'' agent ) to another of different chemical structure. However, as these ''typi cal'' neuroleptics occupy D-2 receptors, the rationale for using a les s conventional antipsychotic, such as clozapine, is increasingly appre ciated in the management of the treatment-refractory schizophrenic.