Schizophrenia: when clozapine fails

Current Opinion in Psychiatry
Seiya MiyamotoW W Fleischhacker

Abstract

This article reviews the recent evidence for therapeutic strategies for patients with treatment-resistant schizophrenia (TRS) not responding to or only partially responding to clozapine. A number of pharmacological and nonpharmacological biological approaches for clozapine-resistant TRS have been evaluated in clinical trials. Among these, the evidence supporting clozapine augmentation by pharmacological approaches is weak and the reported benefits were modest at best. However, the results of a recent randomized trial suggest that electroconvulsive therapy (ECT) may be efficacious for the short-term treatment of patients with clozapine-resistant TRS. There is currently insufficient evidence for efficacy of pharmacological augmentation strategies to clozapine. ECT may be a promising option, but further research is necessary to confirm its long-term effects. Moreover, further controlled studies are warranted to clarify the potential of other biological and psychosocial approaches to serve as adjuvant treatments in patients with clozapine-resistant TRS.

References

Dec 1, 1996·The American Journal of Psychiatry·R W BuchananA Breier
Oct 11, 2001·Journal of Clinical Psychopharmacology·D C GoffG Lynch
Dec 18, 2001·Biological Psychiatry·R R Conley, D L Kelly
Jan 5, 2002·Journal of Psychiatric Research·Malcolm PeetUNKNOWN E-E Multicentre Study Group
Apr 23, 2005·Annals of General Psychiatry·Danilo Arnone
Mar 4, 2006·The American Journal of Psychiatry·Douglas TurkingtonPeter J Weiden
Apr 4, 2006·Schizophrenia Research·Emmanuel PouletMohamed Saoud
Feb 7, 2008·Schizophrenia Research·Jagadisha ThirthalliChittaranjan Andrade
Dec 18, 2008·Pakistan Journal of Biological Sciences : PJBS·A Masoudzadeh, A R Khalilian
Dec 4, 2009·Schizophrenia Bulletin·Robert W BuchananUNKNOWN Schizophrenia Patient Outcomes Research Team (PORT)
Dec 10, 2009·The Journal of Nervous and Mental Disease·Eliza Martha de Paiva BarrettoHelio Elkis
Jul 10, 2010·Journal of Psychopharmacology·M R A MuscatelloR Zoccali
Sep 13, 2011·European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology·Stefano PorcelliAlessandro Serretti
Sep 22, 2011·International Clinical Psychopharmacology·Umberto Mico'Maria Rosaria A Muscatello
Nov 15, 2011·Acta Psychiatrica Scandinavica·D M TaylorJ Nielsen
Mar 1, 2012·Journal of Clinical Psychopharmacology·Paolo Fusar-Poli, Gregor Berger
May 15, 2012·The American Journal of Psychiatry·Jerome BrunelinEmmanuel Poulet
Jul 28, 2012·The World Journal of Biological Psychiatry : the Official Journal of the World Federation of Societies of Biological Psychiatry·Alkomiet HasanUNKNOWN World Federation of Societies of Biological Psychiatry (WFSBP) Task Force on Treatment Guidelines for Schizophrenia
Sep 26, 2012·Clinical Schizophrenia & Related Psychoses·Herbert Y Meltzer
Dec 12, 2012·Schizophrenia Research·Sefa VayısoğluM Kâzım Yazıcı
Dec 10, 2013·Biological Psychiatry·Christina W SlotemaIris E C Sommer
Dec 18, 2013·The Journal of Clinical Psychiatry·Chittaranjan Andrade
Jan 28, 2014·Clinical Psychopharmacology and Neuroscience : the Official Scientific Journal of the Korean College of Neuropsychopharmacology·Sri Mahavir AgarwalGanesan Venkatasubramanian
Apr 2, 2014·Psychiatric Services : a Journal of the American Psychiatric Association·Amy M N BurnsColleen A Brenner
Apr 10, 2014·Evidence-based Mental Health·Markus Dold, Stefan Leucht
Jul 30, 2014·Journal of Psychiatric Research·Seiya MiyamotoW Wolfgang Fleischhacker
Aug 27, 2014·The American Journal of Psychiatry·Georgios PetridesAlan Mendelowitz
Oct 7, 2014·Expert Opinion on Pharmacotherapy·Maria Rosaria A MuscatelloRocco Zoccali

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Citations

Feb 29, 2016·The Lancet. Psychiatry·Mathias Zink, Susanne Englisch
Oct 22, 2016·Neuroscience and Biobehavioral Reviews·Felipe V GomesAnthony A Grace
May 26, 2018·Therapeutic Advances in Drug Safety·Domenico De BerardisMassimo Di Giannantonio
May 16, 2019·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·M V Ivanov, D S Zubov

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