Treatment-refractory schizophrenia

Purpose of review: The aim of this article is to critically review the current literature on treatment-refractory schizophrenia with an emphasis on emergent themes and key findings. Recent findings: New information continues to emerge on the impact of each second-generation antipsychotic on the treatment-refractory patient population and on the traditionally more difficult-to-treat components (e.g. cognition, suicidality, violence) of the illness. There are continued efforts with pharmacogenetics to predict response and side-effect risk with antipsychotic medications. Polypharmacy continues to be a major and poorly understood treatment practice. Summary: Our field is advancing the therapeutic nuances of therapy with second-generation antipsychotics in treatment-refractory schizophrenia. Additionally, there is a growing appreciation of the emergent adverse-effect profile of antipsychotic medications and these risk-benefit considerations are more pronounced in severely ill patients.