Non-Glutamatergic Clozapine Augmentation Strategies: A Review and Meta-Analysis

S. R. T. Veerman; P. F. J. Schulte; M. J. H. Begemann; L. de Haan

doi:10.1055/s-0034-1385930

Pharmacopsychiatry, Table of Contents

Pharmacopsychiatry 2014; 47(07): 231-238
DOI: 10.1055/s-0034-1385930

Review

Non-Glutamatergic Clozapine Augmentation Strategies: A Review and Meta-Analysis

S. R. T. Veerman

¹Flexible Assertive Community Treatment, Mental Health Service Organisation North Holland North, Community Mental Health Division, Alkmaar, The Netherlands

,

P. F. J. Schulte

²Treatment Centre for Bipolar Disorders, Mental Health Service Organisation North Holland North, Division for Specialised Treatment, Alkmaar, The Netherlands

,

M. J. H. Begemann

³Neuroscience Department & Rudolf Magnus Institute for Neuroscience, University Medical Center Utrecht, UMCU, Utrecht, The Netherlands

,

L. de Haan

⁴Early Psychosis Department, AMC, Academic Psychiatric Centre, Amsterdam, The Netherlands

› Author Affiliations

Abstract

Persistent negative symptoms and cognitive impairment are major clinical problems in the treatment of schizophrenia. There is no convincing evidence regarding the efficacy of augmentation of clozapine with a second antipsychotic, ethyl eicosapentaenoic acid (E-EPA), an antidepressant, a mood stabilizer or extract of Ginkgo biloba in clozapine-resistant schizophrenia. We present an overview of studies in which the potential clinical utility of the addition of non-glutamatergic agents to clozapine is assessed. We performed a meta-analysis on the efficacy of both risperidone and aripiprazole compared to placebo. We compared the effects of the addition of a second antipsychotic or an antidepressant to clozapine on positive, negative, overall and affective symptoms of schizophrenia in double-blind placebo-controlled trials.

Key words

schizophrenia - refractory - augmentation - clozapine

Full Text

References

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