An international research agenda for clozapine-resistant schizophrenia
Luykx, Jurjen J; Gonzalez-Diaz, Jairo M; Guu, Ta-Wei; van der Horst, Marte Z; van Dellen, Edwin; Boks, Marco P; Guloksuz, Sinan; DeLisi, Lynn E; Sommer, Iris E; Cummins, Russel; Shiers, David; Lee, Jimmy; Every-Palmer, Susanna; Mhalla, Ahmed; Chadly, Zohra; Chan, Sherry K W; Cotes, Robert O; Takahashi, Shun; Benros, Michael E; Wagner, Elias; Correll, Christoph U; Hasan, Alkomiet; Siskind, Dan; Endres, Dominique; MacCabe, James; Tiihonen, Jari
(2023) The lancet. Psychiatry, volume 10, issue 8, pp. 644 - 652
(Article)
Abstract
Treatment-resistant symptoms occur in about a third of patients with schizophrenia and are associated with a substantial reduction in their quality of life. The development of new treatment options for clozapine-resistant schizophrenia constitutes a crucial, unmet need in psychiatry. Additionally, an overview of past and possible future research avenues to
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optimise the early detection, diagnosis, and management of clozapine-resistant schizophrenia is unavailable. In this Health Policy, we discuss the ongoing challenges associated with clozapine-resistant schizophrenia faced by patients and health-care providers worldwide to improve the understanding of this condition. We then revisit several clozapine guidelines, the diagnostic tests and treatment options for clozapine-resistant schizophrenia, and currently applied research approaches in clozapine-resistant schizophrenia. We also suggest methodologies and targets for future research, divided into innovative nosology-oriented field trials (eg, examining dimensional symptom staging), translational approaches (eg, genetics), epidemiological research (eg, real-world studies), and interventional studies (eg, non-traditional trial designs incorporating lived experiences and caregivers' perspectives). Finally, we note that low-income and middle-income countries are under-represented in studies on clozapine-resistant schizophrenia and propose an agenda to guide multinational research on the cause and treatment of clozapine-resistant schizophrenia. We hope that this research agenda will empower better global representation of patients living with clozapine-resistant schizophrenia and ultimately improve their functional outcomes and quality of life.
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Keywords: Journal Article, Review
ISSN: 2215-0366
Publisher: Elsevier Limited
Note: Funding Information: We are indebted to graphic designer Leny Amaya for helping us with the design of the figure in this Health Policy. Publisher Copyright: © 2023 Elsevier Ltd
(Peer reviewed)