Summary:
The article deals with definition, measurement and treatment possibilities of pharmacoresistant schizophrenia.
Recently, when evaluating pharmacoresistance, we have concentrated especially on persistent symptoms because
there are treatment options preferentially influencing some symptoms (positive, negative, affective symptoms
and cognitive dysfunction). As for treatment possibilities, attention is first paid to the use of high doses of antipsychotic,
i.e. higher doses than officially recommended. Further possibilities include switch to clozapine and
polypharmacotherapy. Clozapine is still considered to be a gold standard in this indication. Polypharmacotherapy,
especially a combination of antipsychotics and augmentation by drugs primary not intended for treatment
of psychosis are very frequent. Based on available data in stabilised schizophrenic patients, it seems that polypharmacotherapy
is abundant in many cases. For this reason the individual medication should be considered carefully
and individually taking into consideration the most troublesome persistent symptoms.
Key words:
pharmacoresistant schizophrenia, antipsychotics, high doses, clozapine, polypharmacotherapy, combination
of antipsychotic, augmentation of antipsychotics.
|