Early Markers in Resistant Schizophrenia: Effect of the First Antipsychotic Drug

Background: Schizophrenia is a mental illness with a multifactorial etiology and clinical presentation. Treatment is mainly with antipsychotic drugs. Despite the increasing number of antipsychotic drugs, there has been no significant change in the percentage of resistant cases. These data gave us re...

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Main Author: Georgi Panov Panov
Format: Article
Language:English
Published: MDPI AG 2022-03-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/12/4/803
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author Georgi Panov Panov
author_facet Georgi Panov Panov
author_sort Georgi Panov Panov
collection DOAJ
description Background: Schizophrenia is a mental illness with a multifactorial etiology and clinical presentation. Treatment is mainly with antipsychotic drugs. Despite the increasing number of antipsychotic drugs, there has been no significant change in the percentage of resistant cases. These data gave us reason to look for a link between the effect of the first individually selected antipsychotic drug and the established resistance to therapy. Method: An assessment has been made of 105 patients with chronic schizophrenia with consecutive psychotic episodes. The choice of antipsychotic has been made on the basis of clinical features, history of efficacy of previously used neuroleptics, anthropometric features, as well as somatic comorbidities. Accidental use of benzodiazepines in anxiety conditions as well as correctors in indications for extrapyramidal problems have been reported. Assessment was made based on clinical observation as well as on changes in PANSS score. Results: Of the 105 observed patients, the effectiveness of the first antipsychotic effect was found in 46.7% of patients. Follow-up of patients for a period of 12 weeks revealed that 45 (42.8%) of them had resistant schizophrenia, while the remaining 60 (57.2%) achieved clinical remission and initial functional recovery. The effect of the first antipsychotic drug was established in 9 (20%) of the patients with resistant schizophrenia and in 40 (66.57%) of the patients in clinical remission. Conclusion: The evaluation of the first antipsychotic medication is significant for the prognosis of patients with schizophrenia. Its lack of effectiveness indicates a high probability of resistance and can be a good indicator of earlier change and a possible search for more “aggressive” measures to prevent future resistance and possible disability.
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spelling doaj.art-76a63d021f8d49f6892921ccdb45467c2023-12-01T01:29:48ZengMDPI AGDiagnostics2075-44182022-03-0112480310.3390/diagnostics12040803Early Markers in Resistant Schizophrenia: Effect of the First Antipsychotic DrugGeorgi Panov Panov0Psychiatric Clinic, University Hospital for Active Treatment “Prof. D-r Stoian Kirkovic”, 6000 Stara Zagora, BulgariaBackground: Schizophrenia is a mental illness with a multifactorial etiology and clinical presentation. Treatment is mainly with antipsychotic drugs. Despite the increasing number of antipsychotic drugs, there has been no significant change in the percentage of resistant cases. These data gave us reason to look for a link between the effect of the first individually selected antipsychotic drug and the established resistance to therapy. Method: An assessment has been made of 105 patients with chronic schizophrenia with consecutive psychotic episodes. The choice of antipsychotic has been made on the basis of clinical features, history of efficacy of previously used neuroleptics, anthropometric features, as well as somatic comorbidities. Accidental use of benzodiazepines in anxiety conditions as well as correctors in indications for extrapyramidal problems have been reported. Assessment was made based on clinical observation as well as on changes in PANSS score. Results: Of the 105 observed patients, the effectiveness of the first antipsychotic effect was found in 46.7% of patients. Follow-up of patients for a period of 12 weeks revealed that 45 (42.8%) of them had resistant schizophrenia, while the remaining 60 (57.2%) achieved clinical remission and initial functional recovery. The effect of the first antipsychotic drug was established in 9 (20%) of the patients with resistant schizophrenia and in 40 (66.57%) of the patients in clinical remission. Conclusion: The evaluation of the first antipsychotic medication is significant for the prognosis of patients with schizophrenia. Its lack of effectiveness indicates a high probability of resistance and can be a good indicator of earlier change and a possible search for more “aggressive” measures to prevent future resistance and possible disability.https://www.mdpi.com/2075-4418/12/4/803resistant schizophreniaantipsychoticsfirst antipsychotic drugeffect of therapytreatment considerationremission consensus schizophrenia
spellingShingle Georgi Panov Panov
Early Markers in Resistant Schizophrenia: Effect of the First Antipsychotic Drug
Diagnostics
resistant schizophrenia
antipsychotics
first antipsychotic drug
effect of therapy
treatment consideration
remission consensus schizophrenia
title Early Markers in Resistant Schizophrenia: Effect of the First Antipsychotic Drug
title_full Early Markers in Resistant Schizophrenia: Effect of the First Antipsychotic Drug
title_fullStr Early Markers in Resistant Schizophrenia: Effect of the First Antipsychotic Drug
title_full_unstemmed Early Markers in Resistant Schizophrenia: Effect of the First Antipsychotic Drug
title_short Early Markers in Resistant Schizophrenia: Effect of the First Antipsychotic Drug
title_sort early markers in resistant schizophrenia effect of the first antipsychotic drug
topic resistant schizophrenia
antipsychotics
first antipsychotic drug
effect of therapy
treatment consideration
remission consensus schizophrenia
url https://www.mdpi.com/2075-4418/12/4/803
work_keys_str_mv AT georgipanovpanov earlymarkersinresistantschizophreniaeffectofthefirstantipsychoticdrug