Clozapine and risperidone: combination/ augmentation treatment of refractory schizophrenia: a preliminary observation

Raskin, Sergey; Katz, Grégory; Zislin, Z.; Knobler, Haim Y.; Durst, Rimona

doi:10.1034/j.1600-0447.2000.101004334.x

Cited by 36 publications

(19 citation statements)

References 9 publications

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“…Nevertheless, they concluded more positively that despite the lack of controlled data, such combinations were safe and might be efficacious for those patients for whom clozapine had produced a less than optimal improvement. Raskin and colleagues 63 questioned the safety of the combination of clozapine and risperidone, pointing to isolated references suggesting adverse reactions such as agranulocytosis 70 and marked elevation of clozapine blood levels.…”

Section: Chong and Remingtonmentioning

confidence: 99%

“…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%

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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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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. Declared competing interests of authors: SW Lewis received support for travel to meetings and honoraria for consultancies from AstraZeneca, Lilly, BristolMyersSquibb, Pfizer, Janssen, Wyeth, Lundbeck, GlaxoSmithKline and Novartis. L Davies received funding for preparing papers and attendance at meetings from Janssen, Hoechst Marion Roussel, Pfizer, AstraZeneca and Lundbeck, and project funding from Novartis. PB Jones received travel support to academic meetings from companies manufacturing drugs used in this study, and unrestricted use of honoraria and consultancy fees for some work for academic use in his department and elsewhere. TRE Barnes received travel support to academic meetings and honoraria for consultancy from companies manufacturing drugs used in this study, plus the award of a grant from Sanofi-Synthelabo for an investigator-initiated study. RM Murray received honoraria and advisory fees from pharmaceutical companies (paid into departmental research funds). R Kerwin received honoraria and advisory fees from pharmaceutical companies and received research grants for non-clinical research from Novartis. D Taylor received honoraria for a lecture and consultancy from manufacturers of atypical antipsy...

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Section: Chong and Remingtonmentioning

confidence: 99%

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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“…Eine ähnlich posi- [105]. Werden Risperidon und Clozapin kombiniert, kommt es zu einem Anstieg des Plasmaspiegels von Clozapin, was für eine bessere Wirksamkeit verantwortlich sein könnte [104,115]. Allerdings gibt es zur Kombination Clozapin/ Risperidon auch eine negative Studie [64].…”

Section: Kombination Verschiedener Antipsychotikaunclassified

Pharmakotherapie der Schizophrenie

Fleischhacker

Hummer

2006

Nervenarzt

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The management of schizophrenia patients remains one of the great challenges in psychiatry. Despite the undisputed effectiveness of antipsychotic drugs, patients and their physicians still face considerable difficulties mainly related to incomplete or lacking treatment response and the inability to predict the individual efficacy and tolerability. In this manuscript we review the key elements of pharmacological treatment of this disorder, encompassing acute and long-term management as well as specific management problems ranging from acutely violent patients to treatment-resistant subjects. Along with general treatment principles, the document provides specific information regarding efficacy and safety features of antipsychotics. Many of the currently available treatment recommendations/guidelines are based on the evidence reviewed here. This review is meant to serve as a guide for clinicians involved in managing schizophrenia, whether in a psychiatric hospital setting or as family physicians in private practice.

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“…Wiederholt wurde in den letzten Jahren auch über erfolgreiche Therapieversuche mit Kombinationen verschiedener Atypika bei therapieresistenten Patienten berichtet.In den meisten Fällen wurde zusätzlich zu Clozapin ein weiteres Atypikum eingesetzt,zumeist Risperidon [52,55,65]. Von Tyson et al wurde ein Anstieg der Clozapinspiegel unter Kombination mit Risperidon beobachtet und dieser pharmakokinetische Effekt für die bessere Wirksamkeit verantwortlich gemacht [75].…”

Section: Kombinationen Von Atypika Als Alternative?unclassified

Atypische Antipsychotika bei therapieresistenter Schizophrenie

Schäfer

Lambert

2004

Nervenarzt

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Many studies have shown that treatment resistance is a substantial problem in schizophrenic patients, with 20-30% of patients responding only partially and about 7% showing no response to antipsychotic treatment. Clozapine has been consistently shown to be effective in this subgroup of schizophrenic patients. It is still the drug of choice, despite the restricted indication and the need for a careful evaluation of side effects. Recently, several double-blind studies of newer atypical antipsychotics have been conducted in therapy-resistant patients. Three studies compared risperidone with clozapine, one study zotepine with clozapine and two others olanzapine with dozapine. One study compared the efficacy of clozapine, olanzapine, risperidone with one another and with haloperidol. In these studies, dozapine showed increasing superiority the more restrictive the criteria for therapy-resistance chosen. Olanzapine was found to be as effective as clozapine and was better tolerated. However, the results of studies comparing different atypical anti-psychotics have to be interpreted carefully because of their limited number as well as methodological problems. Case studies also indicate the efficacy of combining different atypical antipsychotics, but no systematic research on this issue has been done so far.

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Clozapine and risperidone: combination/ augmentation treatment of refractory schizophrenia: a preliminary observation

Abstract: The findings from this pilot study suggest this combination as a possible therapeutic approach for treating resistant schizophrenic patients.

Cited by 36 publications

References 9 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

Pharmakotherapie der Schizophrenie

Atypische Antipsychotika bei therapieresistenter Schizophrenie

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