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The Royal College of Psychiatrists Improving the lives of people with mental illness


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Treatment Resistant Psychosis


People with resistant psychosis are especially familiar to clinicians for a number of reasons. Firstly, they may continue to need a hospital bed, and while in hospital, their persistent symptoms often mean that they require greater input from across the multidisciplinary team. For others, well resourced community services may mean that people, while able to leave hospital, are nevertheless symptomatic and need more frequent community contact. Ongoing psychotic symptoms make it more difficult for someone to reliably engage with treatment programmes, thus increasing the risk of relapse and readmission. People with predominantly negative or cognitive symptoms may require ongoing support from health, social services or both because of their lower levels of functioning. Refractory psychosis not only affects quality of life for the person themselves, but also results in greater pressure on carers and relatives.

This course is designed to help psychiatrists review their management of these patients with greater confidence and to impart some new ideas which might help to break the cycle. This should in turn improve the quality of life of our client group as well as reducing costs of treatment.

The training is designed to have practical applications, so we have included round-table discussions to discuss real-life dilemmas you may have faced in clinical practice with National Psychosis Service (NPS) team members.

This course is eligible for 6 CPD hours subject to your peer group approval.


Topics Include

  • Medication options in resistant psychosis including specific advice on improving the tolerability of Clozapine

  • The latest pharmacological approaches to resistant psychosis and what options exist when Clozapine doesn’t work

  • Psychological therapies including cognitive-behavioural therapy and family work

  • Outcome measures in resistant psychosis

  • Future approaches to treatment resistant psychosis Support Specialist NHS Teams


About the National Psychosis Service (NPS)

The National Psychosis Service specialises in expert, evidence-based treatment for people with resistant, complex or co-morbid psychosis, to enhance their quality of life through rehabilitation and recovery, and reduce the risk of readmission or of expensive long-term care costs. They have an internationally renowned team, pioneering treatment interventions and recovery rates not seen elsewhere. The doctors, nurses, pharmacists, occupational therapists and psychologists who work in the service are experts in their field, with the majority also undertaking research into the causes of psychotic disorders, and the effectiveness of both existing and new treatments. The Service consists of outpatient clinics held at the Maudsley Hospital, an outreach service for people who are unable to come to the Maudsley and a 23-bed inpatient unit at the Bethlem Royal Hospital.

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