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Abstract

DEMOGRAPHIC PROFILE AND MANAGEMENT STRATEGIES OF TREATMENT RESISTANT SCHIZOPHRENIA IN A TERTIARY CARE REFERRAL HOSPITAL

Balasubramanian T1, Lina Elizabeth Cherian1, Mumthas A.H1, Jisna Jamal1, Murshid C.P1, B. Anandhi B3, Balan P2, A.R.Abdul Rasheed1,Karthikeyan M4*

1Department of Pharmacology, Al Shifa College of Pharmacy, Perinthalmanna, Kerala, India

2Department of Pharmaceutical Chemistry, Al Shifa College of Pharmacy, Perinthalmanna, Kerala, India

3The Erode College of pharmacy and research institute, Erode, Tamilnadu, India
4Nirmala College of Pharmacy, Muvattupuzha, Ernakulam, Kerala, India

ABSTRACT

Treatment resistance in schizophrenia is an emerging issue faced by physicians worldwide. This study was undertaken to evaluate the demographic profile and management of Treatment Resistant Schizophrenia (TRS) in psychiatric department of a tertiary care super-specialty hospital. In this prospective observational study, a total of 25 subjects diagnosed with TRS were enrolled. Treatment resistant cases in the hospital setting were identified by using positive and negative syndrome scale (PANSS). We evaluated the demographic profile, major adverse drug reactions, treatment provided for those patients and monitored for improvement of conditions. The demographic profile result shows that the gender doesn’t have much influence on the occurrence of TRS. Family history had a strong correlation with the occurrence of TRS. Clozapine is used as a gold standard in treatment of TRS. Augmentation of clozapine with other antipsychotics has shown clinical improvement in patients. The major ADRs shown by TRS patients include weight gain, constipation, diabetes mellitus, extra pyramidal symptoms, sexual dysfunction and tachycardia. The study concluded that in this specific population of TRS patients who were unresponsive to previous treatment, a combination of clozapine with aripiprazole as well as other augmentation strategies were seen worthy for further exploration.

Keywords: Treatment Resistant Schizophrenia; Clozapine; Aripiprazole; ECT.


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