Pseudo-Resistant Schizophrenia: Non-Adherence to Treatment

Abstract

Treatment-resistant schizophrenia (TRS) has been defined as the persistence of positive symptoms despite two or more trials of antipsychotic medication of adequate dose and duration. TRS is a serious clinical problem and occurs in approximately 30% of patients with schizophrenia. It is important that patients who do not adequately respond to antipsychotics be reevaluated to ex-clude or address causes other than non-responsiveness to medication, that is, the possibility of pseudo-resistance. In particular, non-adherence to oral antipsychotic treatment should be monitored to rule out pseudo-resistant cases of TRS. Moreover, patients with TRS who take their medication as required may have subtherapeutic antipsychotic plasma levels, secondary to pharmacoki-netic factors. In this paper, we review the concept and exclusion of pseudo-resistance, especially owing to non-adherence or phar-macokinetic factors, and present methods to enhance drug adherence. (Korean J Schizophr Res 2020;23:51-57)