Favourable results in treatment-resistant schizophrenic patients under combination of aripiprazole with clozapine.
World J Biol Psychiatry. 2010 Mar; 11(2 Pt 2):502-5.WJ

Abstract

Clozapine is still the gold standard in treatment-resistant schizophrenia. However, a substantial amount of patients do not fully recover on clozapine monotherapy. Though there is still a lack of randomised controlled studies of combination strategies in treatment-resistant schizophrenia, they are widely used. Aripiprazole is a relatively new therapeutic option due to its partial D2 agonism. Both clozapine and aripiprazole, though having a generally favourable side-effect profile, may lead to insufficient response and might provoke side effects in monotherapy. We report the case of four patients in whom we observed a distinct clinical improvement with respect to positive and negative symptoms without major side effects under a combination of clozapine and aripiprazole. The combination of clozapine action and aripiprazole-mediated D(2) receptor regulation could be responsible for the described favourable effects and for the increase of D(2) receptor blockade after adding aripiprazole to clozapine observed in one patient. A combination of clozapine and aripiprazole may be an effective therapeutic strategy for some schizophrenic patients, leading to a good response with respect to positive and negative symptoms without the occurrence of major side effects.

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Authors+Show Affiliations

Mossaheb N
Division of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria. nilufar.mossaheb@meduniwien.ac.at
Spindelegger C
No affiliation info available
Asenbaum S
No affiliation info available
Fischer P
No affiliation info available
Barnas C
No affiliation info available

MeSH

AdultAntipsychotic AgentsAripiprazoleClozapineDrug Therapy, CombinationFemaleHumansMaleMiddle AgedPiperazinesQuinolonesSchizophreniaSchizophrenia, ParanoidTreatment FailureYoung Adult

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

20218805