TY - JOUR
T1 - An international research agenda for clozapine-resistant schizophrenia
AU - Luykx, Jurjen J
AU - Gonzalez-Diaz, Jairo M
AU - Guu, Ta-Wei
AU - van der Horst, Marte Z
AU - van Dellen, Edwin
AU - Boks, Marco P
AU - Guloksuz, Sinan
AU - DeLisi, Lynn E
AU - Sommer, Iris E
AU - Cummins, Russel
AU - Shiers, David
AU - Lee, Jimmy
AU - Every-Palmer, Susanna
AU - Mhalla, Ahmed
AU - Chadly, Zohra
AU - Chan, Sherry K W
AU - Cotes, Robert O
AU - Takahashi, Shun
AU - Benros, Michael E
AU - Wagner, Elias
AU - Correll, Christoph U
AU - Hasan, Alkomiet
AU - Siskind, Dan
AU - Endres, Dominique
AU - MacCabe, James
AU - Tiihonen, Jari
N1 - Funding Information:
We are indebted to graphic designer Leny Amaya for helping us with the design of the figure in this Health Policy.
Publisher Copyright:
© 2023 Elsevier Ltd
PY - 2023/8
Y1 - 2023/8
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85165341293&partnerID=8YFLogxK
U2 - 10.1016/S2215-0366(23)00109-8
DO - 10.1016/S2215-0366(23)00109-8
M3 - Review article
C2 - 37329895
SN - 2215-0366
VL - 10
SP - 644
EP - 652
JO - The lancet. Psychiatry
JF - The lancet. Psychiatry
IS - 8
ER -