Augmentation strategies in partial responder and/or treatment-resistant schizophrenia patients treated with clozapine.

Abstract

INTRODUCTION:

Although clozapine (CLZ) is considered the best evidence-based therapeutic option for treatment of resistant schizophrenia patients, a significant proportion of CLZ-treated patients show a partial or inadequate response to treatment, leading to increased healthcare cost and poor quality of life for affected individuals.

AREAS COVERED:

This paper comprises a review of main research in CLZ augmentation strategies for treatment-refractory schizophrenia, with a focus on research conducted between 1990 and 2014. Databases that were searched include: PubMed, CINAHL, EMBASE PsychINFO, AgeLine and Cochrane Database of Systematic Reviews. Primary search terms were 'clozapine augmentation', 'clozapine and add-on' and 'treatment-resistant schizophrenia', with cross reference to specific agents covered in this article. We reviewed the available evidence on CLZ augmentation with antipsychotics, antidepressants, mood stabilizers and other agents.

EXPERT OPINION:

Many drugs have been evaluated as CLZ add-on therapies without demonstrating convincing efficacy in treating refractory schizophrenia symptoms. More research is needed to better define outcomes in schizophrenia, the topic of treatment-resistance and more well-designed trials are required to establish true efficacy and safety of CLZ augmentation strategies.

• Authors: Maria Rosaria A Muscatello, Antonio Bruno, Pasquale De Fazio, Cristina Segura-Garcia, Gianluca Pandolfo, Rocco Zoccali
• Journal: Expert opinion on pharmacotherapy (Expert Opin Pharmacother) Vol. 15 Issue 16 Pg. 2329-45 (Nov 2014) ISSN: 1744-7666 [Electronic] England
• PMID: 25284216 (Publication Type: Journal Article, Review)

Chemical References

• Anticonvulsants
• Antidepressive Agents
• Antipsychotic Agents
• Clozapine

Topics

• Affect (drug effects)
• Anticonvulsants (therapeutic use)
• Antidepressive Agents (therapeutic use)
• Antipsychotic Agents (therapeutic use)
• Clozapine (therapeutic use)
• Combined Modality Therapy
• Drug Therapy, Combination
• Electroconvulsive Therapy
• Health Care Costs
• Humans
• Quality of Life
• Schizophrenia (drug therapy, physiopathology, therapy)
• Schizophrenic Psychology
• Treatment Failure