Management of schizophrenia : an update.

Introduction of potent antipsychotics for the treatment of schizophrenia not only brought changes in the outlook for management of this disorder but also infused optimism and hope. However, substantial number of patients fail to respond to conventional antipsychotics thus creating a class of patients who are termed as treatment resistant, treatment refractory or difficult to treat patients. This update focuses on such patients and provides description of various options for their management Though atypical antipsychotics offer respite to a vast number of such difficult to treat patients, their efficacy is perhaps over-emphasised. Conversely, the potential of psychosocial therapies in such patients has not been fully exploited. Management of such patients in the community is a challenge and in taking up this gauntlet, a judicious mix of pharmacotherapy and psychosocial intervention strategies, close monitoring of the patients with a view to detect prodromes of relapse and early intervention are likely to play increasingly important part.