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Aripiprazole versus haloperidol in combination with clozapine for treatment-resistant schizophrenia in routine clinical care: a randomized, controlled trial.
J Clin Psychopharmacol. 2011 Jun; 31(3):266-73.JC

Abstract

This multisite study was conducted to compare the efficacy and tolerability of combination treatment with clozapine plus aripiprazole versus combination treatment with clozapine plus haloperidol in patients with schizophrenia who do not have an optimal response to clozapine. Patients continued to take clozapine and were randomly assigned to receive daily augmentation with aripiprazole or haloperidol. Physicians prescribed the allocated treatments according to usual clinical care. Withdrawal from allocated treatment within 3 months was the primary outcome. Secondary outcomes included severity of symptoms on the Brief Psychiatric Rating Scale and antipsychotic subjective tolerability on the Liverpool University Neuroleptic Side Effect Rating Scale. A total of 106 patients with schizophrenia were randomly assigned to treatment. After 3 months, we found no difference in the proportion of patients who discontinued treatment between the aripiprazole and haloperidol groups (13.2% vs 15.1%, P = 0.780). The 3-month change of the Brief Psychiatric Rating Scale total score was similar in the aripiprazole and haloperidol groups (-5.9 vs -4.4 points, P = 0.523), whereas the 3-month decrease of the Liverpool University Neuroleptic Side Effect Rating Scale total score was significantly higher in the aripiprazole group than in the haloperidol group (-7.4 vs -2.0 points, P = 0.006). These results suggest that augmentation of clozapine with aripiprazole offers no benefit with regard to treatment withdrawal and overall symptoms in schizophrenia compared with augmentation with haloperidol. However, an advantage in the perception of adverse effects with aripiprazole treatment may be meaningful for patients.

Authors+Show Affiliations

World Health Organization Collaborating Centre for Research and Training in Mental Health and Service Organization, Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, Verona, Italy. corrado.barbui@univr.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

21508849

Citation

Barbui, Corrado, et al. "Aripiprazole Versus Haloperidol in Combination With Clozapine for Treatment-resistant Schizophrenia in Routine Clinical Care: a Randomized, Controlled Trial." Journal of Clinical Psychopharmacology, vol. 31, no. 3, 2011, pp. 266-73.
Barbui C, Accordini S, Nosè M, et al. Aripiprazole versus haloperidol in combination with clozapine for treatment-resistant schizophrenia in routine clinical care: a randomized, controlled trial. J Clin Psychopharmacol. 2011;31(3):266-73.
Barbui, C., Accordini, S., Nosè, M., Stroup, S., Purgato, M., Girlanda, F., Esposito, E., Veronese, A., Tansella, M., & Cipriani, A. (2011). Aripiprazole versus haloperidol in combination with clozapine for treatment-resistant schizophrenia in routine clinical care: a randomized, controlled trial. Journal of Clinical Psychopharmacology, 31(3), 266-73. https://doi.org/10.1097/JCP.0b013e318219cba3
Barbui C, et al. Aripiprazole Versus Haloperidol in Combination With Clozapine for Treatment-resistant Schizophrenia in Routine Clinical Care: a Randomized, Controlled Trial. J Clin Psychopharmacol. 2011;31(3):266-73. PubMed PMID: 21508849.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aripiprazole versus haloperidol in combination with clozapine for treatment-resistant schizophrenia in routine clinical care: a randomized, controlled trial. AU - Barbui,Corrado, AU - Accordini,Simone, AU - Nosè,Michela, AU - Stroup,Scott, AU - Purgato,Marianna, AU - Girlanda,Francesca, AU - Esposito,Eleonora, AU - Veronese,Antonio, AU - Tansella,Michele, AU - Cipriani,Andrea, AU - ,, PY - 2011/4/22/entrez PY - 2011/4/22/pubmed PY - 2011/8/30/medline SP - 266 EP - 73 JF - Journal of clinical psychopharmacology JO - J Clin Psychopharmacol VL - 31 IS - 3 N2 - This multisite study was conducted to compare the efficacy and tolerability of combination treatment with clozapine plus aripiprazole versus combination treatment with clozapine plus haloperidol in patients with schizophrenia who do not have an optimal response to clozapine. Patients continued to take clozapine and were randomly assigned to receive daily augmentation with aripiprazole or haloperidol. Physicians prescribed the allocated treatments according to usual clinical care. Withdrawal from allocated treatment within 3 months was the primary outcome. Secondary outcomes included severity of symptoms on the Brief Psychiatric Rating Scale and antipsychotic subjective tolerability on the Liverpool University Neuroleptic Side Effect Rating Scale. A total of 106 patients with schizophrenia were randomly assigned to treatment. After 3 months, we found no difference in the proportion of patients who discontinued treatment between the aripiprazole and haloperidol groups (13.2% vs 15.1%, P = 0.780). The 3-month change of the Brief Psychiatric Rating Scale total score was similar in the aripiprazole and haloperidol groups (-5.9 vs -4.4 points, P = 0.523), whereas the 3-month decrease of the Liverpool University Neuroleptic Side Effect Rating Scale total score was significantly higher in the aripiprazole group than in the haloperidol group (-7.4 vs -2.0 points, P = 0.006). These results suggest that augmentation of clozapine with aripiprazole offers no benefit with regard to treatment withdrawal and overall symptoms in schizophrenia compared with augmentation with haloperidol. However, an advantage in the perception of adverse effects with aripiprazole treatment may be meaningful for patients. SN - 1533-712X UR - https://www.unboundmedicine.com/medline/citation/21508849/Aripiprazole_versus_haloperidol_in_combination_with_clozapine_for_treatment_resistant_schizophrenia_in_routine_clinical_care:_a_randomized_controlled_trial_ L2 - https://doi.org/10.1097/JCP.0b013e318219cba3 DB - PRIME DP - Unbound Medicine ER -