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Treatment resistant schizophrenia - review and a call to action.

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posted on 2022-02-24, 12:01 authored by John LallyJohn Lally, Fiona Gaughran

Recovery rates in schizophrenia remain suboptimal with up to one-third resistant to standard treatments, a population prevalence of 0.2%. Clozapine is the only evidenced-based treatment for treatment resistant schizophrenia (TRS), yet there are significant delays in its use or it may not be trialled, potentially impacting the chance of recovery. Better outcomes with earlier use of clozapine may be possible. There is emerging evidence that early treatment resistance is not uncommon from the earliest stages of psychosis. In this review, we provide an update on TRS, its epidemiology and its management, with a specific focus on the optimal use and timing of clozapine and augmentation strategies for the one-third of patients who do not respond to clozapine.


Lundbeck, Otsuka, Sunovion, NHS Innovations/Janssen-Cilag, National Institute for Health Research Collaboration, NIHR Biomedical Research Centre.



This article has been published in a revised form in Irish Journal of Psychological Medicine This version is free to view and download for private research and study only. Not for re-distribution, re-sale or use in derivative works. © copyright holder.

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Lally J, Gaughran F. Treatment resistant schizophrenia - review and a call to action. Irish Journal of Psychological Medicine. 2018;35:1-13

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  • Beaumont Hospital
  • Psychiatry

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