Adjunctive Risperidone Treatment in Patients with ‘Clozapine-Resistant Schizophrenia’

Adesanya, Adesina; Pantelis, Christos

doi:10.1080/j.1440-1614.2000.0751j.x

Cited by 25 publications

(10 citation statements)

References 5 publications

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“…Adjunctive antipsychotics tested include pimozide, 54 sulpiride, 55 olanzapine, 56 loxapine 57 and amisulpride, 58 with reports of further clinical benefit. While the addition of risperidone in a couple of published cases failed to produce any improvement, 59,60 the majority of reports involving this drug have also been positive, 53,[61][62][63][64] For example, in a 4-week, open study, Henderson and Goff 62 assessed the safety and efficacy of risperidone as an adjunct in 12 patients with schizophrenia who continued to show positive and negative symptoms despite treatment with clozapine. Ten of the 12 patients had a 20% or greater reduction in their total BPRS scores, and the investigators considered that controlled trials of this adjunctive therapy were warranted.…”

Section: Combined Antipsychoticsmentioning

confidence: 99%

Randomised controlled trials of conventional antipsychotic versus new atypical drugs, and new atypical drugs versus clozapine, in people with schizophrenia responding poorly to, or intolerant of, current drug treatment

Lewis

Davies²,

Jones³

et al. 2006

Health Technol Assess

135

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Section: Combined Antipsychoticsmentioning

confidence: 99%

Randomised controlled trials of conventional antipsychotic versus new atypical drugs, and new atypical drugs versus clozapine, in people with schizophrenia responding poorly to, or intolerant of, current drug treatment

Lewis

Davies²,

Jones³

et al. 2006

Health Technol Assess

135

View full text Add to dashboard Cite

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“…10,17,18 The clozapine dosage during clozapine monotherapy was at least 300 mg/d for 20 patients (60.6%) included in 14 case studies, less than 300 mg/d for 2 patients in 2 case studies, 10,17 and was not exactly reported in the case study by Bryois and Ferrero including 11 patients. 18 For 16 patients (48.5%) in 11 case studies, 8,9,[11][12][13]15,16,[19][20][21][22] the duration and dosage of clozapine monotherapy were reported as adequate (at least 12 weeks and 300 mg/d, respectively).…”

Section: Methodsmentioning

confidence: 99%

“…10,18 The clozapine dosage during the combined treatment varied widely from 50 to 900 mg/d. 13,18 The duration of the combined treatment also varied widely from 1 week to 15.3 years. 15,18 It was at least 12 weeks for 22 patients (66.6%) included in 10 case studies, less than 12 weeks for 9 patients included in 8 case studies, and was not exactly reported for 2 patients in 2 case studies.…”

Section: Methodsmentioning

confidence: 99%

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Case Studies of Adjunctive Agents in Clozapine-Resistant Schizophrenic Patients

Kontaxakis¹,

Ferentinos²,

Havaki-Kontaxaki³

et al. 2005

Clinical Neuropharmacology

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Approximately 40%-70% of neuroleptic-resistant schizophrenic patients are nonresponders even to clozapine. Several clozapine augmentation strategies have come into clinical practice, although often without evidence-based support. This study aims to critically review all the reported case studies regarding the efficacy and safety of adjunctive agents in clozapine-resistant schizophrenic or schizoaffective patients. All published case studies examining the efficacy and safety of adjunctive agents in clozapine-resistant schizophrenic patients were searched for in the MEDLINE database from January 1980 to February 2004. Case studies regarding ECT as a clozapine augmentation strategy were not included in our study. All the included papers were critically reviewed and examined against a set of clinical and pharmacological parameters, outcome measures, and reported side effects. Fifteen case studies regarding the efficacy and safety of sulpiride, risperidone, olanzapine, lithium, lamotrigine, fluvoxamine, and bromocriptine as clozapine adjuncts were found. A total of 33 schizophrenic or schizoaffective patients were included. Of the 15 studies, 8 were associated with risperidone. The duration and dosage of previous clozapine monotherapy was adequate for 16 patients. Plasma clozapine level was assessed for only 7 patients. Outcome measures were used for only 11 patients. The outcome was positive in 13 studies. Combined treatments were generally well tolerated, and side effects never resulted in discontinuation of treatment. Most case studies favor the use of risperidone as an adjunctive agent in clozapine-resistant schizophrenic or schizoaffective patients. However, small numbers of patients and other methodological shortcomings limit the impact of evidence provided.

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“…While the use of this approach is growing along with the frequent use of polypharmacy in schizophrenia patients (estimated 20%), 115 little research is available to support it. The data derive mostly from case reports and open studies indicating improved efficacy of clozapine treatment following the addition of risperidone, [116][117][118][119][120][121][122] olanzapine, 123 or typical agents, such as pimozide and sulpiride. [124][125][126] However, the rationale behind this strategy remains elusive and the supportive data are doubtful.…”

Section: Combined Antipsychotic Drugsmentioning

confidence: 99%

Treatment–Refractory Schizophrenia

Buckley

Gaughran

2014

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Adjunctive Risperidone Treatment in Patients with ‘Clozapine-Resistant Schizophrenia’

Cited by 25 publications

References 5 publications

Randomised controlled trials of conventional antipsychotic versus new atypical drugs, and new atypical drugs versus clozapine, in people with schizophrenia responding poorly to, or intolerant of, current drug treatment

Randomised controlled trials of conventional antipsychotic versus new atypical drugs, and new atypical drugs versus clozapine, in people with schizophrenia responding poorly to, or intolerant of, current drug treatment

Case Studies of Adjunctive Agents in Clozapine-Resistant Schizophrenic Patients

Treatment–Refractory Schizophrenia

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