CHARACTERISTICS OF SUPER-REFRACTORY SCHIZOPHRENIA

Approximately 30% of treatment-resistant schizophrenic patients do not fully respond to Clozapine and such patients are termed Clozapine non-responders or super-refractory schizophrenics. The aim of this study was to characterize patients with super-refractory schizophrenia according to demographic and psychopathological variables, as compared with patients with refractory schizophrenia or non-refractory subjects. The aim of this study was to characterize patients with super-refractory schizophrenia according to demographic and psychopathological variables, as compared with patients with refractory schizophrenia. We conducted a 6-month cohort study with patients undergoing pharmacological treatment for schizophrenia. We compared demographical and clinical aspects of three groups: schizophrenic patients who responded other antipsychotics than Clozapine, Clozapine responders (refractory patients), and Clozapine non-responders (super-refractory patients). Sixty seven patients were included in the study. The mean age was 35 years (± 2.9) across groups. Most patients were male (71%) and the mean age at onset of the disorder across groups was 22.5 years (± 4.4) while the mean age at first hospitalization was 23 (± 5.1). Of the 67 patients, 15 (23%) were classified as responders, 31 (46%) being refractory (Clozapine responders) and 21 (31%) super-refractory. The super-refractory group had the highest scores for totals of BPRS (p<0.01) in all visits. Patients who do not benefit from the first prescribed drug will not benefit from any pharmacological intervention. These efforts must result in a more specific definition of TRS, as well as in a better understanding of the illness pathophysiology and the mechanism of action of the drugs.