Benzodiazepines as adjunctive therapy in treatment refractory symptoms of schizophrenia.

Antipsychotics are a key intervention strategy in pharmacotherapy in schizophrenia. However, the benzodiazepines are often prescribed to control sleep disturbances, anxiety or hostile behaviour. There is some evidence supporting the combination therapy with antipsychotics and benzodiazepines providing beneficiary treatment effect to the psychosis in positive and negative symptom domains as well as catatonia or adverse reactions to antipsychotic drugs. In particular, in a population suffering from residual symptoms of schizophrenia, in particular anxiety, emotional flattening, being refractory to approved treatment strategies, benzodiazepines as add-on to antipsychotics seem to be an option. There is rationale for the therapeutic use for long-acting benzodiazepines as the treatment of option with limited literature indicating the use of chlordiazepoxide, and diazepam. The paper reviews the best clinical practice indications for benzodiazepines as the add-on treatment to antipsychotics in schizophrenia.