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A large proportion of patients with schizophrenia fail to respond adequately to their medications and can be considered as treatment-refractory, Dr. Stephen R. Marder declared. The advent of newer atypical antipsychotics requires an expanded definition of treatment refractoriness and more thoughtful application of treatment alternatives to the traditional dopamine receptor antagonists. In this context, Dr. Marder discussed positive symptoms and broadened the definition of patients who could be considered treatment- refractory.