氯氮平
精神分裂症(面向对象编程)
精神科
生活质量(医疗保健)
医学
临床试验
心理学
心理治疗师
病理
作者
Jurjen J. Luykx,Jairo M. González-Díaz,Ta‐Wei Guu,Marte Z. van der Horst,Edwin van Dellen,Marco P. Boks,Sinan Gülöksüz,Lynn E. DeLisi,Iris E. Sommer,Russel Cummins,David Shiers,Jimmy Lee,Susanna Every‐Palmer,Ahmed Mhalla,Zohra Chadly,Sherry Kit Wa Chan,Robert O. Cotes,Shun Takahashi,Michael E. Benros,Elias Wagner
标识
DOI:10.1016/s2215-0366(23)00109-8
摘要
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 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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