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Long-term efficacy and tolerability of clozapine combined with ziprasidone or risperidone.
Pharmacopsychiatry. 2010 Aug; 43(6):216-20.P

Abstract

INTRODUCTION

Treatment resistance in schizophrenia often leads to add-on of atypical antipsychotics to clozapine.

METHODS

In a randomized trial, we recently obtained evidence for comparable efficacy and differential side effects of clozapine in combination with ziprasidone (CZ, N=12) versus risperidone (CR, N=12). Here, we present the open-label, long-term evaluations of these patients after 26 and 52 weeks.

RESULTS

Sustained improvements of psychopathology as assessed by PANSS (positive and negative syndrome scale), SANS (scale for the assessment of negative symptoms), and HAMD (Hamilton depression scale) were documented in both subsamples being treated according to protocol, while dropouts reduced the study sample after 26 (CZ: reduced by -4; CR: -2) and 52 weeks (CZ: -0; CR: -5). We observed a slight increase of akathisia in the CZ group whereas general clozapine-associated side effects improved.

DISCUSSION

The combinations of clozapine with ziprasidone or risperidone exhibit long-term efficacy, but the level of evidence is limited. Further head-to-head comparisons of atypical antipsychotics as add-on to clozapine are necessary.

Authors+Show Affiliations

Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, University of Heidelberg, Mannheim, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20589598

Citation

Kuwilsky, A, et al. "Long-term Efficacy and Tolerability of Clozapine Combined With Ziprasidone or Risperidone." Pharmacopsychiatry, vol. 43, no. 6, 2010, pp. 216-20.
Kuwilsky A, Krumm B, Englisch S, et al. Long-term efficacy and tolerability of clozapine combined with ziprasidone or risperidone. Pharmacopsychiatry. 2010;43(6):216-20.
Kuwilsky, A., Krumm, B., Englisch, S., Dressing, H., & Zink, M. (2010). Long-term efficacy and tolerability of clozapine combined with ziprasidone or risperidone. Pharmacopsychiatry, 43(6), 216-20. https://doi.org/10.1055/s-0030-1254089
Kuwilsky A, et al. Long-term Efficacy and Tolerability of Clozapine Combined With Ziprasidone or Risperidone. Pharmacopsychiatry. 2010;43(6):216-20. PubMed PMID: 20589598.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term efficacy and tolerability of clozapine combined with ziprasidone or risperidone. AU - Kuwilsky,A, AU - Krumm,B, AU - Englisch,S, AU - Dressing,H, AU - Zink,M, Y1 - 2010/06/29/ PY - 2010/7/1/entrez PY - 2010/7/1/pubmed PY - 2011/2/9/medline SP - 216 EP - 20 JF - Pharmacopsychiatry JO - Pharmacopsychiatry VL - 43 IS - 6 N2 - INTRODUCTION: Treatment resistance in schizophrenia often leads to add-on of atypical antipsychotics to clozapine. METHODS: In a randomized trial, we recently obtained evidence for comparable efficacy and differential side effects of clozapine in combination with ziprasidone (CZ, N=12) versus risperidone (CR, N=12). Here, we present the open-label, long-term evaluations of these patients after 26 and 52 weeks. RESULTS: Sustained improvements of psychopathology as assessed by PANSS (positive and negative syndrome scale), SANS (scale for the assessment of negative symptoms), and HAMD (Hamilton depression scale) were documented in both subsamples being treated according to protocol, while dropouts reduced the study sample after 26 (CZ: reduced by -4; CR: -2) and 52 weeks (CZ: -0; CR: -5). We observed a slight increase of akathisia in the CZ group whereas general clozapine-associated side effects improved. DISCUSSION: The combinations of clozapine with ziprasidone or risperidone exhibit long-term efficacy, but the level of evidence is limited. Further head-to-head comparisons of atypical antipsychotics as add-on to clozapine are necessary. SN - 1439-0795 UR - https://www.unboundmedicine.com/medline/citation/20589598/Long_term_efficacy_and_tolerability_of_clozapine_combined_with_ziprasidone_or_risperidone_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0030-1254089 DB - PRIME DP - Unbound Medicine ER -