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Risperidone augmentation of clozapine

A critical review

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European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

Objective

Atypical antipsychotics are frequently used as augmentation agents in clozapine-resistant schizophrenic patients. Risperidone (RIS) is the one most studied as a clozapine (CLZ) adjunct. The aim of this study is to critically review all published studies regarding the efficacy and safety of RIS as an adjunctive agent in CLZ-resistant schizophrenic or schizoaffective patients.

Methods

A MEDLINE search from January 1988 to June 2005 was conducted. Identified papers were examined against several clinical, pharmacological and methodological parameters.

Results

A total of 15 studies were found (2 randomized controlled trials, 3 open-label trials (OTs) and 8 case-studies (CSs)) comprising 86 schizophrenic or schizoaffective patients (mean age 38.4 years). Mean CLZ dosage during the combined treatment was 474.2 mg/day. Plasma CLZ levels were assessed in 62 patients (72.1%). RIS was added at a mean dosage of 4.6 mg/day for a mean of 7.9 weeks. Significant improvement in psychopathology was reported for 37 patients (43%). A lower RIS dosage and a longer duration of the trial seemed to be associated with a better outcome. Main side effects reported were: extrapyramidal symptoms or akathisia (9.3%), sedation (7%) and hypersalivation (5.8%).

Conclusions

Existing evidence encourages the use of RIS as an adjunctive agent in CLZ-resistant schizophrenic or schizoaffective patients.

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Authors and Affiliations

  1. Department of Psychiatry, University of Athens, Eginition Hospital, 74 Vas.Sophias Ave., 11528, Athens, Greece

    Vassilis P. Kontaxakis MD, PhD, Panayotis P. Ferentinos MD, Beata J. Havaki-Kontaxaki MD, PhD, Konstantinos G. Paplos MD, Dimitra A. Pappa MD & George N. Christodoulou MD, FICPM, FRCPsych

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  1. Vassilis P. Kontaxakis MD, PhD
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  2. Panayotis P. Ferentinos MD
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  3. Beata J. Havaki-Kontaxaki MD, PhD
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  4. Konstantinos G. Paplos MD
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  5. Dimitra A. Pappa MD
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  6. George N. Christodoulou MD, FICPM, FRCPsych
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Correspondence to Vassilis P. Kontaxakis MD, PhD.

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Kontaxakis, V.P., Ferentinos, P.P., Havaki-Kontaxaki, B.J. et al. Risperidone augmentation of clozapine. Eur Arch Psychiatry Clin Neurosci 256, 350–355 (2006). https://doi.org/10.1007/s00406-006-0643-9

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  • DOI: https://doi.org/10.1007/s00406-006-0643-9

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