Adjuvant Galantamine Administration Improves Negative Symptoms in a Patient With Treatment-Refractory Schizophrenia

2002 ◽  
Vol 25 (5) ◽  
pp. 272-275 ◽  
Author(s):  
Richard B. Rosse ◽  
Stephen I. Deutsch
Keyword(s):  
Negative Symptoms ◽  
Treatment Refractory

scholarly journals Treatment-refractory and super refractory schizophrenia - a case study

2017 ◽  
Vol 18 (4) ◽  
pp. 292-299
Author(s):  
Ewelina Soroka ◽  
Inga-Ujma Lesiczka ◽  
Magdalena Tracz ◽  
Bernarda Bereza ◽  
Marcin Olajossy
Keyword(s):  
Drug Resistance ◽  
Social Relations ◽  
Negative Symptoms ◽  
Paranoid Schizophrenia ◽  
Diagnostic Category ◽  
Classification Systems ◽  
Response To Treatment ◽  
Convulsive Therapy ◽  
Long Period ◽  
Treatment Refractory

AbstractRefractoriness affects about 25% of patients treated with antipsychotics, and it is a very big challenge for clinicians. The most commonly accepted definition of refractoriness is: lack of satisfactory clinical response to treatment with at least two antipsychotic drugs, from different groups, carried out at therapeutic doses and for a sufficiently long period.Aim : The aim of the study is to analyze the case of a patient diagnosed with schizophrenia.Methods: Analysis of medical records, available literature from recent years on treatment-refractory and super-refractory schizophrenia.Results: A 53-year-old patient, a bachelor, suffering from paranoid schizophrenia with an extremely severe, non-remission course with drug resistance features. The patient's father and sister also suffer from severe paranoid schizophrenia. The patient became ill at the age of 22. Despite the high doses of clozapine, in a sufficiently long period of time, the patient maintained positive and negative symptoms, cognitive deficits and behavioral disorders. The patient was 14 times psychiatrically hospitalized, twice treated with electro-convulsive therapy, which did not bring results despite the combination of electroconvulsive therapywith psycho pharmacotherapy. In addition, the patient was addicted to benzodiazepines, administered during anxiety and anxiety attacks by the mother, during the described hospitalization, gradually discontinued. Patient after several attempts of committing suicide, with a tendency to self-destructive behavior. The illustrated case meets the criteria of super-refractory schizophrenia (SRS).Conclusions: 1. The category of refractory schizophrenia encountered in the literature is not a separate diagnostic category - it does not exist in classification systems, therefore we consider the phenomenon / symptom of drug resistance - variously defined. 2. Social relations have a big impact on the functioning of the patient as well as the course of the disease and prognosis (the role of the family). 3. There are numerous methods for the potentiating of clozapine treatment, of which combining clozapine with EC therapy is effective and safe. The strategy for combining clozapine with EC is effective, but not in all patients.

scholarly journals Clozapine-induced intestinal obstruction - a critical examination of four cases

2006 ◽  
Vol 12 (1) ◽  
pp. 4
Author(s):  
C Seller ◽  
L Koen ◽  
D J H Niehaus
Keyword(s):  
Side Effects ◽  
Negative Symptoms ◽  
Critical Examination ◽  
Antipsychotic Treatment ◽  
Extrapyramidal Side Effects ◽  
Atypical Antipsychotic Drug ◽  
Superior Efficacy ◽  
Added Benefit ◽  
Treatment Refractory ◽  
Positive And Negative Symptoms

Clozapine is an atypical antipsychotic drug indicated for the management of severely ill patients with schizophrenia who fail to respond adequately to standard antipsychotic treatment. It has demonstrated superior efficacy in treating both the positive and negative symptoms in treatment-refractory cases. It also has the added benefit of causing minimal extrapyramidal side- effects, producing no tardive dyskinesia and having little effect on prolactin levels

Issues of Choice in Second-Generation Antipsychotic Agents

1998 ◽  
Vol 43 (1_suppl) ◽  
pp. 7S-9S
Author(s):  
Michael Teehan
Keyword(s):  
Negative Symptoms ◽  
Second Generation ◽  
Antipsychotic Agents ◽  
Clinical Scenario ◽  
Elderly Female ◽  
Second Generation Antipsychotics ◽  
Second Generation Antipsychotic ◽  
Treatment Refractory ◽  
New Treatments ◽  
Withdrawal Effects

Objectives: To identify and describe the most significant issues in optimal clinical use of the second-generation antipsychotics. Methods: A case report of an elderly female with treatment-refractory psychosis, negative symptoms, and tardive dyskinesia is used to focus the discussion of the clinical decisions. The rationale for switching, the choice of an appropriate compound, and the practical issues of transition from her present treatment are addressed. Conclusions: The case illustrates a common clinical scenario, focusing on the practical clinical issues in changing treatments. It draws attention to the need to carefully monitor the switch from traditional to second-generation antipsychotics. This is particularly important in patients with severe symptoms, so as not to confuse withdrawal effects from present medications with apparent failure of the new treatments.

scholarly journals Clozapine v. first- and second-generation antipsychotics in treatment-refractory schizophrenia: systematic review and meta-analysis

2016 ◽  
Vol 209 (5) ◽  
pp. 385-392 ◽  
Author(s):  
Dan Siskind ◽  
Lara McCartney ◽  
Romi Goldschlager ◽  
Steve Kisely
Keyword(s):  
Systematic Review ◽  
Negative Symptoms ◽  
Meta Analysis ◽  
Number Needed To Treat ◽  
Clozapine Treatment ◽  
Second Generation Antipsychotics ◽  
Treatment Refractory ◽  
Randomised Controlled ◽  
Meta Analyses ◽  
First And Second Generation

BackgroundAlthough clozapine is the ‘gold standard’ for treatment-refractory schizophrenia, meta-analyses of clozapine for this condition are lacking.AimsWe conducted a systematic review and meta-analysis of clozapine treatment for people with treatment-refractory schizophrenia.MethodWe searched the Cochrane Schizophrenia Group's trial register, PubMed and EMBASE and hand-searched key papers for randomised controlled trials of clozapine for treatment-refractory schizophrenia.ResultsTwenty-one papers with 25 comparisons were included. The number needed to treat was 9. Clozapine was superior for positive symptoms in both the short and long term. In the short term only clozapine was superior for total and negative symptoms, with higher response rates. Both funding source and dosage affected results. Higher baseline psychosis scores predicted better outcomes for clozapine in a meta-regression.ConclusionsClozapine is superior for treatment-refractory disorder but if there is no response by 6 months medications with lower adverse reactions should be considered.

Adjunctive minocycline in clozapine and amisulpride treated schizophrenia patients with persistent symptoms

2017 ◽  
Vol 41 (S1) ◽  
pp. s842-s842
Author(s):  
E. Tzavellas ◽  
D. Karaiskos ◽  
J. Konstantinou ◽  
E. Oikonomou ◽  
R. Soldatos ◽  
...  
Keyword(s):  
Working Memory ◽  
Marked Reduction ◽  
Negative Symptoms ◽  
Recent Literature ◽  
Persistent Symptoms ◽  
Global Cognitive Function ◽  
Schizophrenic Patients ◽  
Treatment Refractory ◽  
Competing Interest ◽  
Oral Capsule

ObjectiveClozapine and amisulpride are two effective antipsychotic and their combination often is used for treatment refractory people with schizophrenia, yet many patients partially respond. Clinical data and the recent literature suggest benefits with minocycline. in our study we adjunct minocycline in five schizophrenic patients and we observed them for a period of 6 months.MethodsOur patients received adjunct minocycline (100 mg oral capsule twice daily).ResultsUsing the PANSS, we identified a statistically significant (P < 0.05) clinical improvement from the fourth week of treatment for positive mainly, and less for negative symptoms in all our patients. Global cognitive function did not differ, although there was a significant improvement in working memory favoring minocycline. Moreover there was a marked reduction of anxiety and depressive symptoms.Minocycline was well tolerated and no patient presented side effects.ConclusionMinocycline seems to help significantly schizophrenic patients who do not respond fully to their medication consisted of clozapine and amisulpride. Larger studies are needed to validate these findings.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Clozapine's effect on negative symptoms in treatment-refractory schizophrenics

1993 ◽  
Vol 9 (2-3) ◽  
pp. 245
Author(s):  
D.D. Miller ◽  
P.J. Perry ◽  
R.J. Cadoret ◽  
N.C. Andreasen
Keyword(s):  
Negative Symptoms ◽  
Treatment Refractory

Clozapine's effect on negative symptoms in treatment-refractory schizophrenics

1994 ◽  
Vol 35 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Del D. Miller ◽  
Paul J. Perry ◽  
Remi J. Cadoret ◽  
Nancy C. Andreasen
Keyword(s):  
Negative Symptoms ◽  
Treatment Refractory

The concept of negative symptoms: definition, specificity, and significance

1987 ◽  
Vol 2 (4) ◽  
pp. 240-249 ◽  
Author(s):  
Nancy C. Andreasen
Keyword(s):  
Pattern Recognition ◽  
Major Depression ◽  
Negative Symptoms ◽  
Positive Symptoms ◽  
Neuroleptic Drugs ◽  
Treatment Refractory ◽  
Positive And Negative Symptoms

SummaryNegative symptoms are sometimes assumed to be specific to schizophrenia, but in fact they are not. This paper examines the frequency of negative symptoms in schizophrenia, mania, and major depression and indicates that both positive and negative symptoms may occur in all three. Clinicians judge these disorders to be present, not by observing a single pathognomonic symptom or group of symptoms, but rather by a process of pattern recognition of the characteristic clustering of symptoms. In addition to being diagnostically nonspecific, negative symptoms can also be produced by a broad range of factors, including positive symptoms, depression, and neuroleptic drugs. Research attempting to determine whether negative symptoms are treatment-refractory or treatment-responsive must take these factors into account.

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