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Indian J Psychiatry. 2004 Apr-Jun; 46(2): 125–134.
PMCID: PMC2949927

Concept and Management of Treatment Resistant Schizophrenia (TRS)


Treatment resistance in schizophrenia is a fairly common problem faced by psychiatrists worldwide. The concept and definition of Treatment Resistant Schizophrenia (TRS) is still far from satisfactory. Data suggests the presence of biological factors underlying TRS. Second generation antipsychotics are advocated for patients with TRS. However, till date, clozapine remains the treatment of choice. Evidence for other pharmacological measures and ECT is accumulating. Psychosocial interventions do form an integral component of management of TRS. It can be concluded that, with advances in sychopharmacology, TRS needs to be better researched and managed in the future.

Keywords: Schizophrenia, treatment resistant, clozapine, a typical antipsychotics, difficult to treat schizophrenia

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  • Azorin JM, Spiegel R, Remington G, Vanelle JM, Péré JJ, Giguere M, Bourdeix I. A double-blind comparative study of clozapine and risperidone in the management of severe chronic schizophrenia. Am J Psychiatry. 2001 Aug;158(8):1305–1313. [PubMed]
  • Barnes TR, McEvedy CJ. Pharmacological treatment strategies in the non-responsive schizophrenic patient. Int Clin Psychopharmacol. 1996 May;11 (Suppl 2):67–71. [PubMed]
  • Bondolfi G, Dufour H, Patris M, May JP, Billeter U, Eap CB, Baumann P. Risperidone versus clozapine in treatment-resistant chronic schizophrenia: a randomized double-blind study. The Risperidone Study Group. Am J Psychiatry. 1998 Apr;155(4):499–504. [PubMed]
  • Breier A, Hamilton SH. Comparative efficacy of olanzapine and haloperidol for patients with treatment-resistant schizophrenia. Biol Psychiatry. 1999 Feb 15;45(4):403–411. [PubMed]
  • Breier A, Buchanan RW, Irish D, Carpenter WT., Jr Clozapine treatment of outpatients with schizophrenia: outcome and long-term response patterns. Hosp Community Psychiatry. 1993 Dec;44(12):1145–1149. [PubMed]
  • Brenner HD, Dencker SJ, Goldstein MJ, Hubbard JW, Keegan DL, Kruger G, Kulhanek F, Liberman RP, Malm U, Midha KK. Defining treatment refractoriness in schizophrenia. Schizophr Bull. 1990;16(4):551–561. [PubMed]
  • Carman JS, Bigelow LB, Wyatt RJ. Lithium combined with neuroleptics in chronic schizophrenic and schizoaffective patients. J Clin Psychiatry. 1981 Mar;42(3):124–128. [PubMed]
  • Chakos M, Lieberman J, Hoffman E, Bradford D, Sheitman B. Effectiveness of second-generation antipsychotics in patients with treatment-resistant schizophrenia: a review and meta-analysis of randomized trials. Am J Psychiatry. 2001 Apr;158(4):518–526. [PubMed]
  • Chakos MH, Alvir JM, Woerner MG, Koreen A, Geisler S, Mayerhoff D, Sobel S, Kane JM, Borenstein M, Lieberman JA. Incidence and correlates of tardive dyskinesia in first episode of schizophrenia. Arch Gen Psychiatry. 1996 Apr;53(4):313–319. [PubMed]
  • Chanpattana W. Maintenance ECT in treatment-resistant schizophrenia. J Med Assoc Thai. 2000 Jun;83(6):657–662. [PubMed]
  • Chanpattana W, Chakrabhand ML, Sackeim HA, Kitaroonchai W, Kongsakon R, Techakasem P, Buppanharun W, Tuntirungsee Y, Kirdcharoen N. Continuation ECT in treatment-resistant schizophrenia: a controlled study. J ECT. 1999 Sep;15(3):178–192. [PubMed]
  • Chouinard G, Vainer JL, Bélanger MC, Turnier L, Beaudry P, Roy JY, Miller R. Risperidone and clozapine in the treatment of drug-resistant schizophrenia and neuroleptic-induced supersensitivity psychosis. Prog Neuropsychopharmacol Biol Psychiatry. 1994 Nov;18(7):1129–1141. [PubMed]
  • Christison GW, Kirch DG, Wyatt RJ. When symptoms persist: choosing among alternative somatic treatments for schizophrenia. Schizophr Bull. 1991;17(2):217–245. [PubMed]
  • Claghorn J, Honigfeld G, Abuzzahab FS, Sr, Wang R, Steinbook R, Tuason V, Klerman G. The risks and benefits of clozapine versus chlorpromazine. J Clin Psychopharmacol. 1987 Dec;7(6):377–384. [PubMed]
  • Conley RR, Kelly DL. Management of treatment resistance in schizophrenia. Biol Psychiatry. 2001 Dec 1;50(11):898–911. [PubMed]
  • Conley RR, Tamminga CA, Kelly DL, Richardson CM. Treatment-resistant schizophrenic patients respond to clozapine after olanzapine non-response. Biol Psychiatry. 1999 Jul 1;46(1):73–77. [PubMed]
  • Conley RR, Buchanan RW. Evaluation of treatment-resistant schizophrenia. Schizophr Bull. 1997;23(4):663–674. [PubMed]
  • Crow TJ, Ferrier IN, Johnstone EC. The two-syndrome concept and neuroendocrinology of schizophrenia. Psychiatr Clin North Am. 1986 Mar;9(1):99–113. [PubMed]
  • Dean CE. Severe self-injurious behavior associated with treatment-resistant schizophrenia: treatment with maintenance electroconvulsive therapy. J ECT. 2000 Sep;16(3):302–308. [PubMed]
  • Dossenbach MRK, Beuzen JN, Avnon M, Belmaker RH, Elizur A, Mark M, Munitz H, Schneidman M, Shoshani D, Kratky P, et al. The effectiveness of olanzapine in treatment-refractory schizophrenia when patients are nonresponsive to or unable to tolerate clozapine. Clin Ther. 2000 Sep;22(9):1021–1034. [PubMed]
  • Drapalski AL, Rosse RB, Peebles RR, Schwartz BL, Marvel CL, Deutsch SI. Topiramate improves deficit symptoms in a patient with schizophrenia when added to a stable regimen of antipsychotic medication. Clin Neuropharmacol. 2001 Sep-Oct;24(5):290–294. [PubMed]
  • Dursun SM, Deakin JF. Augmenting antipsychotic treatment with lamotrigine or topiramate in patients with treatment-resistant schizophrenia: a naturalistic case-series outcome study. J Psychopharmacol. 2001 Dec;15(4):297–301. [PubMed]
  • Dursun SM, Devarajan S. Clozapine weight gain, plus topiramate weight loss. Can J Psychiatry. 2000 Mar;45(2):198–198. [PubMed]
  • Emsley RA, Raniwalla J, Bailey PJ, Jones AM. A comparison of the effects of quetiapine ('seroquel') and haloperidol in schizophrenic patients with a history of and a demonstrated, partial response to conventional antipsychotic treatment. PRIZE Study Group. Int Clin Psychopharmacol. 2000 May;15(3):121–131. [PubMed]
  • Essock SM, Hargreaves WA, Dohm FA, Goethe J, Carver L, Hipshman L. Clozapine eligibility among state hospital patients. Schizophr Bull. 1996;22(1):15–25. [PubMed]
  • Falloon IR, Boyd JL, McGill CW, Williamson M, Razani J, Moss HB, Gilderman AM, Simpson GM. Family management in the prevention of morbidity of schizophrenia. Clinical outcome of a two-year longitudinal study. Arch Gen Psychiatry. 1985 Sep;42(9):887–896. [PubMed]
  • Falloon IR, Boyd JL, McGill CW, Razani J, Moss HB, Gilderman AM. Family management in the prevention of exacerbations of schizophrenia: a controlled study. N Engl J Med. 1982 Jun 17;306(24):1437–1440. [PubMed]
  • Farde L, Nordström AL, Wiesel FA, Pauli S, Halldin C, Sedvall G. Positron emission tomographic analysis of central D1 and D2 dopamine receptor occupancy in patients treated with classical neuroleptics and clozapine. Relation to extrapyramidal side effects. Arch Gen Psychiatry. 1992 Jul;49(7):538–544. [PubMed]
  • Friedman J, Ault K, Powchik P. Pimozide augmentation for the treatment of schizophrenic patients who are partial responders to clozapine. Biol Psychiatry. 1997 Sep 15;42(6):522–523. [PubMed]
  • Garety PA, Fowler D, Kuipers E. Cognitive-behavioral therapy for medication-resistant symptoms. Schizophr Bull. 2000;26(1):73–86. [PubMed]
  • Goswami Utpal, Kumar Unnati, Singh Baljit. Efficacy of Electroconvulsive Therapy in Treatment Resistant Schizophreinia : A double-blind study. Indian J Psychiatry. 2003 Jan;45(1):26–29. [PMC free article] [PubMed]
  • Green MF, Marshall BD, Jr, Wirshing WC, Ames D, Marder SR, McGurk S, Kern RS, Mintz J. Does risperidone improve verbal working memory in treatment-resistant schizophrenia? Am J Psychiatry. 1997 Jun;154(6):799–804. [PubMed]
  • Gupta S, Sonnenberg SJ, Frank B. Olanzapine augmentation of clozapine. Ann Clin Psychiatry. 1998 Sep;10(3):113–115. [PubMed]
  • Hegarty JD, Baldessarini RJ, Tohen M, Waternaux C, Oepen G. One hundred years of schizophrenia: a meta-analysis of the outcome literature. Am J Psychiatry. 1994 Oct;151(10):1409–1416. [PubMed]
  • Hollister LE, Trevino ES. Calcium channel blockers in psychiatric disorders: a review of the literature. Can J Psychiatry. 1999 Sep;44(7):658–664. [PubMed]
  • Hosák L, Libiger J. Antiepileptic drugs in schizophrenia: a review. Eur Psychiatry. 2002 Nov;17(7):371–378. [PubMed]
  • James DV, Gray NS. Elective combined electroconvulsive and clozapine therapy. Int Clin Psychopharmacol. 1999 Mar;14(2):69–72. [PubMed]
  • Johns CA, Thompson JW. Adjunctive treatments in schizophrenia: pharmacotherapies and electroconvulsive therapy. Schizophr Bull. 1995;21(4):607–619. [PubMed]
  • Juarez-Reyes MG, Shumway M, Battle C, Bacchetti P, Hansen MS, Hargreaves WA. Effects of stringent criteria on eligibility for clozapine among public mental health clients. Psychiatr Serv. 1995 Aug;46(8):801–806. [PubMed]
  • Kales HC, Dequardo JR, Tandon R. Combined electroconvulsive therapy and clozapine in treatment-resistant schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry. 1999 Apr;23(3):547–556. [PubMed]
  • Kane JM. Management strategies for the treatment of schizophrenia. J Clin Psychiatry. 1999;60 (Suppl 12):13–17. [PubMed]
  • Kane JM. Treatment-resistant schizophrenic patients. J Clin Psychiatry. 1996;57 (Suppl 9):35–40. [PubMed]
  • Kane JM, Marder SR. Psychopharmacologic treatment of schizophrenia. Schizophr Bull. 1993;19(2):287–302. [PubMed]
  • Kane J, Honigfeld G, Singer J, Meltzer H. Clozapine for the treatment-resistant schizophrenic. A double-blind comparison with chlorpromazine. Arch Gen Psychiatry. 1988 Sep;45(9):789–796. [PubMed]
  • Keck PE, Jr, Wilson DR, Strakowski SM, McElroy SL, Kizer DL, Balistreri TM, Holtman HM, DePriest M. Clinical predictors of acute risperidone response in schizophrenia, schizoaffective disorder, and psychotic mood disorders. J Clin Psychiatry. 1995 Oct;56(10):466–470. [PubMed]
  • Kee KS, Kern RS, Marshall BD, Jr, Green MF. Risperidone versus haloperidol for perception of emotion in treatment-resistant schizophrenia: preliminary findings. Schizophr Res. 1998 May 25;31(2-3):159–165. [PubMed]
  • Kinon BJ, Kane JM, Johns C, Perovich R, Ismi M, Koreen A, Weiden P. Treatment of neuroleptic-resistant schizophrenic relapse. Psychopharmacol Bull. 1993;29(2):309–314. [PubMed]
  • Leff J, Berkowitz R, Shavit N, Strachan A, Glass I, Vaughn C. A trial of family therapy versus a relatives' group for schizophrenia. Two-year follow-up. Br J Psychiatry. 1990 Oct;157:571–577. [PubMed]
  • Leff J, Berkowitz R, Shavit N, Strachan A, Glass I, Vaughn C. A trial of family therapy v. a relatives group for schizophrenia. Br J Psychiatry. 1989 Jan;154:58–66. [PubMed]
  • Lerner V, Chudakova B, Kravets S, Polyakova I. Combined use of risperidone and olanzapine in the treatment of patients with resistant schizophrenia: a preliminary case series report. Clin Neuropharmacol. 2000 Sep-Oct;23(5):284–286. [PubMed]
  • Leucht Stefan, McGrath John, White Paul, Kissling Werner. Carbamazepine augmentation for schizophrenia: how good is the evidence? J Clin Psychiatry. 2002 Mar;63(3):218–224. [PubMed]
  • Levinson DF, Simpson GM, Singh H, Yadalam K, Jain A, Stephanos MJ, Silver P. Fluphenazine dose, clinical response, and extrapyramidal symptoms during acute treatment. Arch Gen Psychiatry. 1990 Aug;47(8):761–768. [PubMed]
  • Lieberman JA, Safferman AZ, Pollack S, Szymanski S, Johns C, Howard A, Kronig M, Bookstein P, Kane JM. Clinical effects of clozapine in chronic schizophrenia: response to treatment and predictors of outcome. Am J Psychiatry. 1994 Dec;151(12):1744–1752. [PubMed]
  • Lieberman J, Jody D, Geisler S, Alvir J, Loebel A, Szymanski S, Woerner M, Borenstein M. Time course and biologic correlates of treatment response in first-episode schizophrenia. Arch Gen Psychiatry. 1993 May;50(5):369–376. [PubMed]
  • Marder SR. Management of treatment-resistant patients with schizophrenia. J Clin Psychiatry. 1996;57 (Suppl 11):26–30. [PubMed]
  • Martín J, Gómez JC, García-Bernardo E, Cuesta M, Alvarez E, Gurpegui M. Olanzapine in treatment-refractory schizophrenia: results of an open-label study. The Spanish Group for the Study of Olanzapine in Treatment-Refractory Schizophrenia. J Clin Psychiatry. 1997 Nov;58(11):479–483. [PubMed]
  • Mauri Massimo C, Volonteri Lucia S, Dell'Osso Bernardo, Regispani Francesca, Papa Pietro, Baldi Marialuisa, Bareggi Silvio R. Predictors of clinical outcome in schizophrenic patients responding to clozapine. J Clin Psychopharmacol. 2003 Dec;23(6):660–664. [PubMed]
  • McEvoy JP, Hogarty GE, Steingard S. Optimal dose of neuroleptic in acute schizophrenia. A controlled study of the neuroleptic threshold and higher haloperidol dose. Arch Gen Psychiatry. 1991 Aug;48(8):739–745. [PubMed]
  • McFarlane WR, Lukens E, Link B, Dushay R, Deakins SA, Newmark M, Dunne EJ, Horen B, Toran J. Multiple-family groups and psychoeducation in the treatment of schizophrenia. Arch Gen Psychiatry. 1995 Aug;52(8):679–687. [PubMed]
  • McGlashan TH. A selective review of recent North American long-term followup studies of schizophrenia. Schizophr Bull. 1988;14(4):515–542. [PubMed]
  • Meltzer HY, Lee M, Cola P. The evolution of treatment resistance: biologic implications. J Clin Psychopharmacol. 1998 Apr;18(2 Suppl 1):5S–11S. [PubMed]
  • Meltzer HY. An overview of the mechanism of action of clozapine. J Clin Psychiatry. 1994 Sep;55 (Suppl B):47–52. [PubMed]
  • Meltzer HY. Defining treatment refractoriness in schizophrenia. Schizophr Bull. 1990;16(4):563–565. [PubMed]
  • Miller AL, Chiles JA, Chiles JK, Crismon ML, Rush AJ, Shon SP. The Texas Medication Algorithm Project (TMAP) schizophrenia algorithms. J Clin Psychiatry. 1999 Oct;60(10):649–657. [PubMed]
  • Miller R, Chouinard G. Loss of striatal cholinergic neurons as a basis for tardive and L-dopa-induced dyskinesias, neuroleptic-induced supersensitivity psychosis and refractory schizophrenia. Biol Psychiatry. 1993 Nov 15;34(10):713–738. [PubMed]
  • Molina Vicente, Reig Santiago, Sarramea Fernando, Sanz Javier, Francisco Artaloytia Juan, Luque Rogelio, Aragüs María, Pascau Javier, Benito Carlos, Palomo Tomás, et al. Anatomical and functional brain variables associated with clozapine response in treatment-resistant schizophrenia. Psychiatry Res. 2003 Nov 30;124(3):153–161. [PubMed]
  • Moncrieff Joanna. Clozapine v. conventional antipsychotic drugs for treatment-resistant schizophrenia: a re-examination. Br J Psychiatry. 2003 Aug;183:161–166. [PubMed]
  • Mowerman S, Siris SG. Adjunctive loxapine in a clozapine-resistant cohort of schizophrenic patients. Ann Clin Psychiatry. 1996 Dec;8(4):193–197. [PubMed]
  • Muijen M, Marks IM, Connolly J, Audini B, McNamee G. The daily living programme. Preliminary comparison of community versus hospital-based treatment for the seriously mentally ill facing emergency admission. Br J Psychiatry. 1992 Mar;160:379–384. [PubMed]
  • Murray RM, O'Callaghan E, Castle DJ, Lewis SW. A neurodevelopmental approach to the classification of schizophrenia. Schizophr Bull. 1992;18(2):319–332. [PubMed]
  • Pato CN, Wolkowitz OM, Rapaport M, Schulz SC, Pickar D. Benzodiazepine augmentation of neuroleptic treatment in patients with schizophrenia. Psychopharmacol Bull. 1989;25(2):263–266. [PubMed]
  • Peuskens J. The evolving definition of treatment resistance. J Clin Psychiatry. 1999;60 (Suppl 12):4–8. [PubMed]
  • Quitkin F, Rifkin A, Klein DF. Very high dosage vs standard dosage fluphenazine in schizophrenia. A double-blind study of nonchronic treatment-refractory patients. Arch Gen Psychiatry. 1975 Oct;32(10):1276–1281. [PubMed]
  • Raskin S, Katz G, Zislin Z, Knobler HY, Durst R. Clozapine and risperidone: combination/augmentation treatment of refractory schizophrenia: a preliminary observation. Acta Psychiatr Scand. 2000 Apr;101(4):334–336. [PubMed]
  • Revicki DA, Luce BR, Weschler JM, Brown RE, Adler MA. Cost-effectiveness of clozapine for treatment-resistant schizophrenic patients. Hosp Community Psychiatry. 1990 Aug;41(8):850–854. [PubMed]
  • Rodriguez VM, Catalina ML, García-Noblejas JA, Cuesta P. Schizophrenic syndromes and clozapine response in treatment-resistant schizophrenia. Psychiatry Res. 1998 Jan 16;77(1):21–28. [PubMed]
  • Rosberg J, Stunden AA. The use of direct confrontation: the treatment-resistant schizophrenic patient. Acta Psychiatr Scand. 1990 Apr;81(4):352–358. [PubMed]
  • Ruskin P, Averbukh I, Belmaker RH, Dasberg H. Benzodiazepines in chronic schizophrenia. Biol Psychiatry. 1979 Jun;14(3):557–558. [PubMed]
  • Sajatovic M, Meltzer HY. The Effect of Short-Term Electroconvulsive Treatment Plus Neuroleptics in Treatment-Resistant Schizophrenia and Schizoaffective Disorder. Convuls Ther. 1993;9(3):167–175. [PubMed]
  • Sanders RD, Mossman D. An open trial of olanzapine in patients with treatment-refractory psychoses. J Clin Psychopharmacol. 1999 Feb;19(1):62–66. [PubMed]
  • Schooler NR, Keith SJ, Severe JB, Matthews SM, Bellack AS, Glick ID, Hargreaves WA, Kane JM, Ninan PT, Frances A, et al. Relapse and rehospitalization during maintenance treatment of schizophrenia. The effects of dose reduction and family treatment. Arch Gen Psychiatry. 1997 May;54(5):453–463. [PubMed]
  • Schulz SC, Thompson PA, Jacobs M, Ninan PT, Robinson D, Weiden PJ, Yadalam K, Glick ID, Odbert CL. Lithium augmentation fails to reduce symptoms in poorly responsive schizophrenic outpatients. J Clin Psychiatry. 1999 Jun;60(6):366–372. [PubMed]
  • Seeley William W, Turetsky Neil, Reus Victor I, Wolkowitz Owen M. Benzodiazepines in schizophrenia: prefrontal cortex atrophy predicts clinical response to alprazolam augmentation. World J Biol Psychiatry. 2002 Oct;3(4):221–224. [PubMed]
  • Shalev A, Hermesh H, Rothberg J, Munitz H. Poor neuroleptic response in acutely exacerbated schizophrenic patients. Acta Psychiatr Scand. 1993 Feb;87(2):86–91. [PubMed]
  • Shiloh R, Zemishlany Z, Aizenberg D, Radwan M, Schwartz B, Dorfman-Etrog P, Modai I, Khaikin M, Weizman A. Sulpiride augmentation in people with schizophrenia partially responsive to clozapine. A double-blind, placebo-controlled study. Br J Psychiatry. 1997 Dec;171:569–573. [PubMed]
  • Shore D, Matthews S, Cott J, Lieberman JA. Clinical implications of clozapine discontinuation: report of an NIMH workshop. Schizophr Bull. 1995;21(2):333–338. [PubMed]
  • Small Joyce G, Klapper Marietta H, Malloy Frederick W, Steadman Timothy M. Tolerability and efficacy of clozapine combined with lithium in schizophrenia and schizoaffective disorder. J Clin Psychopharmacol. 2003 Jun;23(3):223–228. [PubMed]
  • Small JG, Kellams JJ, Milstein V, Moore J. A placebo-controlled study of lithium combined with neuroleptics in chronic schizophrenic patients. Am J Psychiatry. 1975 Dec;132(12):1315–1317. [PubMed]
  • Smith TE, Docherty JP. Standards of care and clinical algorithms for treating schizophrenia. Psychiatr Clin North Am. 1998 Mar;21(1):203–220. [PubMed]
  • Stahl SM. Antipsychotic polypharmacy, Part 1: Therapeutic option or dirty little secret? J Clin Psychiatry. 1999 Jul;60(7):425–426. [PubMed]
  • Tarrier N, Barrowclough C, Porceddu K, Fitzpatrick E. The Salford Family Intervention Project: relapse rates of schizophrenia at five and eight years. Br J Psychiatry. 1994 Dec;165(6):829–832. [PubMed]
  • Tarrier N, Lowson K, Barrowclough C. Some aspects of family interventions in schizophrenia. II: Financial considerations. Br J Psychiatry. 1991 Oct;159:481–484. [PubMed]
  • Tarrier N, Barrowclough C, Vaughn C, Bamrah JS, Porceddu K, Watts S, Freeman H. Community management of schizophrenia. A two-year follow-up of a behavioural intervention with families. Br J Psychiatry. 1989 May;154:625–628. [PubMed]
  • Tarrier N, Barrowclough C, Vaughn C, Bamrah JS, Porceddu K, Watts S, Freeman H. The community management of schizophrenia. A controlled trial of a behavioural intervention with families to reduce relapse. Br J Psychiatry. 1988 Oct;153:532–542. [PubMed]
  • Taylor CG, Flynn SW, Altman S, Ehmann T, MacEwan GW, Honer WG. An open trial of risperidone augmentation of partial response to clozapine. Schizophr Res. 2001 Mar 1;48(1):155–158. [PubMed]
  • Telles C, Karno M, Mintz J, Paz G, Arias M, Tucker D, Lopez S. Immigrant families coping with schizophrenia. Behavioral family intervention v. case management with a low-income Spanish-speaking population. Br J Psychiatry. 1995 Oct;167(4):473–479. [PubMed]
  • Terkelsen KG, Grosser RC. Estimating clozapine's cost to the nation. Hosp Community Psychiatry. 1990 Aug;41(8):863–869. [PubMed]
  • Thomas SG, Labbate LA. Management of treatment-resistant schizophrenia with olanzapine. Can J Psychiatry. 1998 Mar;43(2):195–196. [PubMed]
  • Torrey EF. Management of chronic schizophrenic outpatients. Psychiatr Clin North Am. 1986 Mar;9(1):143–151. [PubMed]
  • Van Putten T, Marder SR, Mintz J. A controlled dose comparison of haloperidol in newly admitted schizophrenic patients. Arch Gen Psychiatry. 1990 Aug;47(8):754–758. [PubMed]
  • Wassef AA, Dott SG, Harris A, Brown A, O'Boyle M, Meyer WJ, 3rd, Rose RM. Randomized, placebo-controlled pilot study of divalproex sodium in the treatment of acute exacerbations of chronic schizophrenia. J Clin Psychopharmacol. 2000 Jun;20(3):357–361. [PubMed]
  • Weinberger DR. From neuropathology to neurodevelopment. Lancet. 1995 Aug 26;346(8974):552–557. [PubMed]
  • Wirshing DA, Marshall BD, Jr, Green MF, Mintz J, Marder SR, Wirshing WC. Risperidone in treatment-refractory schizophrenia. Am J Psychiatry. 1999 Sep;156(9):1374–1379. [PubMed]
  • Wolkowitz OM, Turetsky N, Reus VI, Hargreaves WA. Benzodiazepine augmentation of neuroleptics in treatment-resistant schizophrenia. Psychopharmacol Bull. 1992;28(3):291–295. [PubMed]

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