精神医学65巻4号

2023年04月発行

特集 わが国の若手による統合失調症研究最前線

治療抵抗性統合失調症の臨床研究

著者： 金原信久¹

所属機関： ¹千葉大学社会精神保健教育研究センター

ページ範囲：P.455 - P.462

抄録
　治療抵抗性統合失調症（TRS）は統合失調症患者において少なくとも2種類の抗精神病薬による治療を実施しても，十分な改善が得られない場合に該当する。治療法が限られ，またそれらでさえ十分な効果が得られないことも多く，現在の精神医学において重要な課題である。2010年以降研究が増えてきており，脳画像研究やpolygenic risk scoreによる遺伝子研究などからTRSがその他の統合失調症とは生物学的に異なる病態と捉えられるようになってきた。またTRS移行やクロザピン反応性に関する予測因子に関する知見から，より早期の診断とより早期のクロザピン導入を目指す方向が重視されつつある。診断において有用かつ簡便な検査・評価法は確立されてはいないこと，また治療に関してはクロザピンなど選択肢が限られていることが課題であり，今後さらなる研究の発展が望まれる。

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