Difference between treatment-resistant schizophrenia and clozapine-resistant schizophrenia

doi:10.5498/wjp.v12.i8.1102

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World Journal of Psychiatry

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Letter to the Editor

World J Psychiatry. Aug 19, 2022; 12(8): 1102-1104
Published online Aug 19, 2022. doi: 10.5498/wjp.v12.i8.1102

Difference between treatment-resistant schizophrenia and clozapine-resistant schizophrenia

Ping-Tao Tseng, Mu-Hong Chen, Chih-Sung Liang

Ping-Tao Tseng, Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung 804, Taiwan

Mu-Hong Chen, Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan

Chih-Sung Liang, Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei 112, Taiwan

Author contributions: Tseng PT and Chen MH designed research; Chen MH and Liang CS performed research; Tseng PT and Liang CS analyzed data; Tseng PT wrote the letter; and Chen MH and Liang CS revised the letter.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Corresponding author: Chih-Sung Liang, MD, Assistant Professor, Attending Doctor, Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, No. 60 Xinmin Road, Beitou District, Taipei 112, Taiwan. lcsyfw@gmail.com

Received: September 4, 2021
Peer-review started: September 4, 2021
First decision: November 8, 2021
Revised: November 19, 2021
Accepted: July 11, 2022
Article in press: July 11, 2022
Published online: August 19, 2022
Processing time: 347 Days and 7.5 Hours

Abstract

We read the impressive review article “Clozapine resistant schizophrenia: Newer avenues of management” with great enthusiasm and appreciation. The author believes that preventing clozapine resistance from developing may be the most effective treatment strategy for patients with clozapine-resistant schizophrenia (CRS), and optimizing clozapine treatment is a key component. Disentangling the differences between treatment-resistant schizophrenia and CRS is important for studies addressing treatment strategies for these difficult-to-treat populations.

Keywords: Treatment-resistant schizophrenia; Clozapine; Clozapine-resistant schizo-phrenia; Ultra-resistant schizophrenia; Ultra-treatment-resistant schizophrenia; Super-refractory schizophrenia

Core Tip: A diagnosis of clozapine-resistant schizophrenia (CRS) is made after administering an adequate trial of clozapine and excluding “pseudo-resistance” in patients who have been diagnosed with treatment-resistant schizophrenia (TRS). Disentangling the differences between TRS and CRS is important point for studies addressing treatment strategies for patients with CRS.