Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
6815879 | Psychiatry Research | 2012 | 6 Pages |
Abstract
Treatment-resistant schizophrenia (TRS) has been defined mainly by severity of (positive) symptoms and response to antipsychotics derived from a relative change in the representative scales (most frequently â¥Â 20% decrease in the Positive and Negative Syndrome Scale: PANSS), but these definitions have not necessarily been consistent. Integrating past evidence and real-world practicability, we propose that TRS be defined by at least two failed adequate trials with different antipsychotics (at chlorpromazine-equivalent doses of â¥Â 600 mg/day for â¥Â 6 consecutive weeks) that could be retrospective or preferably include prospective failure to respond to one or more antipsychotic trials. In addition, our proposed criteria require both a score of â¥Â 4 on the Clinical Global Impression (CGI)-Severity and a score of â¤Â 49 on the Functional Assessment for Comprehensive Treatment of Schizophrenia (FACT-Sz) or â¤Â 50 on the Global Assessment of Functioning (GAF) scales to define TRS. Once TRS is established, we propose that subsequent treatment response be defined based on a CGI-Change score of â¤Â 2, a â¥Â 20% decrease on the total PANSS or Brief Psychiatric Rating Scale (BPRS) scores, and an increase of â¥Â 20 points on the FACT-Sz or GAF. While these suggestions provide a pragmatic framework for TRS classification, they need to be tested in future trials.
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Authors
Takefumi Suzuki, Gary Remington, Benoit H. Mulsant, Hiroyuki Uchida, Tarek K. Rajji, Ariel Graff-Guerrero, Masaru Mimura, David C. Mamo,