CHRONIC-SCHIZOPHRENIA - OPTIONS FOR PHARMACOLOGICAL MANAGEMENT

Clozapine (Clozaril) is currently the most effective drug for treatment-resistant schizophrenia. A trial of clozapine or the newer risperidone (Risperdal) should be offered to patients who cannot tolerate or are resistant to older antipsychotic medications. For patients unable to accept or incur the risks of clozapine, adjunctive drug therapy to a standard neuroleptic regimen is a second-line alternative. Risperidone may offer the benefits of clozapine with reduced risk; thus far, it does not appear to cause agranulocytosis. However, further study is needed to confirm the expectations of its superior efficacy against schizophrenia. The advantages and hazards of any pharmacologic regimen must be considered before choosing the most favorable treatment for an individual patient.