School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand;
Neuropsychiatr Dis Treat. 2011;7:135-49. doi: 10.2147/NDT.S12769. Epub 2011 Mar 17.
Schizophrenia is a disabling mental illness with a lifetime prevalence of 0.7% worldwide and significant, often devastating, consequences on social and occupational functioning. A range of antipsychotic medications are available; however, suboptimal therapeutic response in terms of psychotic symptoms is common and affects up to one-third of people with schizophrenia. Negative symptoms are generally less amenable to treatment. Because of the consequences of inadequate symptom control, effective treatment strategies are required for people with treatment-resistant schizophrenia. Clozapine has been shown to be more effective than other antipsychotics in treatment-resistant populations in several studies; however, the occurrence of adverse effects, some of which are potentially life-threatening, are important limitations. In addition to those who are intolerant to clozapine, only 30% to 50% experience clinically significant symptom improvement. This review describes the recent evidence for treatment strategies for people not responding to nonclozapine antipsychotic agents and people not responding or only partially responding to clozapine.
精神分裂症是一种致残性精神疾病，全球终生患病率为 0.7%，对社会和职业功能有重大影响，往往具有毁灭性。有多种抗精神病药物可供选择；然而，在精神病症状方面，治疗反应并不理想的情况很常见，高达三分之一的精神分裂症患者受到影响。阴性症状通常更难治疗。由于症状控制不足的后果，需要为治疗抵抗性精神分裂症患者制定有效的治疗策略。在几项研究中，氯氮平已被证明比其他抗精神病药在治疗抵抗人群中更有效；然而，不良影响的发生，其中一些可能危及生命，是一个重要的限制。除了那些不能耐受氯氮平的人之外，只有 30%到 50%的人经历了临床显著的症状改善。这篇综述描述了最近针对非氯氮平抗精神病药物治疗反应不佳和氯氮平治疗反应不佳或仅部分反应患者的治疗策略的证据。
