Schizophrenia is a chronic, disabling mental illness associated with significant morbidity, and a reduced life-expectancy of at least 13 to 15 years.1
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Competency standards addressed (2016): 1.1, 1.6, 2.2, 2.3, 4.2
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While schizophrenia is not a common mental illness, with global prevalence rates under 1%,2 up to 30% of individuals experience treatment-refractory (also known as treatment-resistant) schizophrenia.3 This term is typically used when an individual continues to have recurrent or relatively severe positive, negative and/or cognitive symptoms, often with accompanying emotional distress or disability, despite receiving adequate treatment.4 Current guidelines suggest that adequate treatment involves trialling at least two different antipsychotics, with RANZCP practice guidelines and eTG referring to a reasonable trial period of at least six weeks.4,5
While there is significant variability in how treatment-refractory schizophrenia has been defined,6,7 clozapine is well recognised as the most appropriate medicine due to its superior efficacy,8 and associated reduction in hospitalisation9 and mortality ra
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