Comparative Analysis of Combination Therapy Regimens in Patients with Paranoid Schizophrenia with Non-Suicidal Auto aggression and Identified Signs of Resistance to Ongoing Neuroleptic Monotherapy

Abstract

A comparative analysis of combination therapy regimens was carried out in patients with paranoid schizophrenia with NSAA and identified signs of resistance to ongoing neuroleptic monotherapy. In total, in the period from 2015 to 2022, 155 patients with paranoid schizophrenia with NSAA were studied as part of a multicenter randomized longitudinal study. It has been established that the first-line therapy regimen in this group of patients is a combined regimen of clozapine with haloperidol.Introduction. The increase in the number of therapeutically resistant patients with paranoid schizophrenia with auto aggression remains one of the most pressing problems in psychiatry remains as the most common nosological unit [1,2,3]. At the same time, a large amount of research material has been accumulated on the factors and conditions that affect the formation of the state of resistance in such patients [4,5,6,7]. First of all, these include: a debut at an early age, an "erased" beginning, a continuous course, the dominance of negative symptoms in the structure of the pathological process, and the fading of the affective component. A special place among the clinical predictors of therapeutic resistance is occupied by psychopathic disorders with auto aggressive tendencies, traditionally considered within the framework of heboid states. At the same time, until recently, the main drug from the group of neuroleptics used to overcome resistance was clozapine [8,9,10,11,12,13]. In practice, up to 30% of patients remain intact to its action, which dictates the need for combination therapy [14,15,16]. This predetermines the search for new schemes for the use of medicinal drugs to solve this problem.