For patients diagnosed with chronic schizophrenia, up to 30% are believed to meet the threshold to be deemed as having treatment-resistant schizophrenia (TRS). The term of TRS is generally applied to patients who did not report any improvement after a first-line treatment of antipsychotics, as well as a failure to show improved symptoms after up to two additional lines of antipsychotic treatments. Although it remains unclear how an individual patient’s TRS may be moored to clinical or neurobiological pathways, it does impact their families and caregivers, as well as delivering higher levels of functional limitations to the patient. The importance of recognizing TRS earlier on in the course of a patient’s diagnosis is discussed, allowing for increased evaluation of potential alternative treatments and a more patient-inclusive shared decision making process.

Reference: Kane JM, Agid O, Baldwin ML, et al. Clinical Guidance on the Identification and Management of Treatment-Resistant Schizophrenia. J Clin Psychiatry. 2019;80(2):18com12123. doi:10.4088/JCP.18com12123