Which of the following is a second-generation antipsychotic that is commonly used for treatment-resistant schizophrenia?

Which of the following is a second-generation antipsychotic that is commonly used for treatment-resistant schizophrenia?

• A. Haloperidol
• B. Clozapine
• C. Loxapine
• D. Perphenazine

Answer: (B)

Treating treatment-resistant schizophrenia relies on using an atypical antipsychotic with proven effectiveness when other medications have failed. Clozapine is the standout in this scenario because it has robust evidence of improving symptoms in patients who don’t respond to standard antipsychotics, and it can also reduce suicidality associated with schizophrenia. It’s usually considered after failure of at least two other antipsychotics. The trade-off is that it carries serious risks, notably agranulocytosis, so patients require regular blood monitoring and enrollment in a monitoring program. The other drugs listed are older typical antipsychotics with higher risks of extrapyramidal side effects and don’t have the same demonstrated benefit for treatment-resistant cases.

Treating treatment-resistant schizophrenia relies on using an atypical antipsychotic with proven effectiveness when other medications have failed. Clozapine is the standout in this scenario because it has robust evidence of improving symptoms in patients who don’t respond to standard antipsychotics, and it can also reduce suicidality associated with schizophrenia. It’s usually considered after failure of at least two other antipsychotics. The trade-off is that it carries serious risks, notably agranulocytosis, so patients require regular blood monitoring and enrollment in a monitoring program. The other drugs listed are older typical antipsychotics with higher risks of extrapyramidal side effects and don’t have the same demonstrated benefit for treatment-resistant cases.