Antipsychotics: treatment-resistant schizophrenia: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Antipsychotics: treatment-resistant schizophrenia

Sample item

A patient with schizophrenia continues to have disabling hallucinations after adequate trials of two different antipsychotics, each for at least 6 weeks and with confirmed adherence. The next appropriate drug is:

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Clozapine

Treatment resistance is usually defined as failure of two adequate antipsychotic trials, and clozapine is the only agent with proven superior efficacy in this group. It also reduces suicidality in schizophrenia, though it needs blood monitoring.

Option by option

  • A. Diazepam

    Benzodiazepines may calm agitation but do not treat psychosis.

  • B. A third conventional antipsychotic

    A further trial of a similar antipsychotic is unlikely to help.

  • C. Lithium alone

    Lithium alone has no established antipsychotic role.

  • D. Clozapine (correct)

    Correct. Clozapine is indicated for treatment-resistant schizophrenia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is D, Clozapine. Treatment resistance is usually defined as failure of two adequate antipsychotic trials, and clozapine is the only agent with proven superior efficacy in this group.

Why is "Diazepam" not the answer?

Benzodiazepines may calm agitation but do not treat psychosis.

Why is "A third conventional antipsychotic" not the answer?

A further trial of a similar antipsychotic is unlikely to help.

Why is "Lithium alone" not the answer?

Lithium alone has no established antipsychotic role.

What concept does this question test?

It tests Antipsychotics: treatment-resistant schizophrenia in Psychiatry. It also reduces suicidality in schizophrenia, though it needs blood monitoring.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antipsychotics: treatment-resistant schizophrenia?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.