Session Description:

Despite the existence of more than 60 antipsychotic therapeutic agents globally 20-30% of schizophrenia patients are resistant to treatment. There is a direct correlation between treatment initiation and improved clinical outcomes in treatment-resistant schizophrenia (TRS), thus defining treatment resistance in schizophrenia patients is utmost important, so that appropriate treatment can be administered as early as possible. Clozapine is the only evidence-based, effective, and approved treatment for TRS. Despite the evidence for its use, clozapine continues to be highly underutilized and initiated late. Failure to recognize TRS is an important clinical barrier to earlier initiation of clozapine. Clinicians should routinely, actively assess patients with schizophrenia for inadequate response to treatment. In his talk Professor Ofer Agid will review the clinical and biological aspects of treatment response and treatment resistance in first-episode schizophrenia, discuss an algorithm-based treatment approach and emphasize the importance of early positioning of clozapine to reduce the duration of active psychosis. Professor Swaran Singh in his lecture will talk about the barriers and list the various factors leading to clozapine’s underutilization and, in many cases, to its delayed initiation. He will also share practical advice and actions needed to overcome these barriers.

Session Description:

Cognitive impairment associated with schizophrenia (CIAS) is a central feature of the condition and is associated with deficits across multiple cognitive domains. CIAS is a significant predictor of real-world functioning, affecting one’s ability to live independently, be gainfully employed, and have meaningful interpersonal relationships. Existing pharmacological treatments for schizophrenia fall short in meeting the need associated with cognitive impairments, and non-pharmacological therapies, while recommended by current treatment guidelines, are limited in their ability to mitigate CIAS symptoms. This session will elucidate the current understanding of CIAS and its underlying physiology; explain the importance of dopaminergic and glutamatergic signaling, including the potential role of the N-methyl-D-aspartate (NMDA) receptor and glycine transporter type-1 (GlyT1) function in cognition; and highlight the impact of CIAS from the patient perspective. This compelling session will then discuss GlyT1 inhibition as a potential target for CIAS and present Phase II data on Boehringer Ingelheim’s investigational therapeutic GlyT1 inhibitor, BI 425809.