title: [Refractory schizophrenia].
abstract: OBJECTIVE
  The aim of the present paper is to review the various aspects of refractory schizophrenia regarding issues such as definitions, clinical aspects, psychobiological correlates, pharmacological and non-pharmacological treatment options and predictors of treatment response.
  
  
  METHODS
  Medline search as well as articles of the authors.
  
  
  CONCLUSIONS
  Refractory schizophrenia affects at least one third of patients with schizophrenia and the best evidence shows that is monotherapy with clozapine remains the mainstay for the treatment of such condition. Antipsychotic polipharmacy is not supported by current evidence and recent clinical trials have shown that clozapine augmentation with antipsychotics has no benefit over placebo.
authors.affiliation: Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. helkis@usp.br
authors.forename: Helio
authors.initials: H
authors.lastname: Elkis
authors.forename: Herbert Y
authors.initials: HY
authors.lastname: Meltzer
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D003024:Clozapine / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D006801:Humans; D019338:Polypharmacy; D012559:Schizophrenia / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D003024:Clozapine
vernacular_title: Esquizofrenia refratária.