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Pharmacopsychiatry 2014; 47(07): 231-238
DOI: 10.1055/s-0034-1385930
Review
© Georg Thieme Verlag KG Stuttgart · New York

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

S. R. T. Veerman
1   Flexible Assertive Community Treatment, Mental Health Service Organisation North Holland North, Community Mental Health Division, Alkmaar, The Netherlands
,
P. F. J. Schulte
2   Treatment Centre for Bipolar Disorders, Mental Health Service Organisation North Holland North, Division for Specialised Treatment, Alkmaar, The Netherlands
,
M. J. H. Begemann
3   Neuroscience Department & Rudolf Magnus Institute for Neuroscience, University Medical Center Utrecht, UMCU, Utrecht, The Netherlands
,
L. de Haan
4   Early Psychosis Department, AMC, Academic Psychiatric Centre, Amsterdam, The Netherlands
› Author Affiliations
Further Information

Publication History

received 14 May 2014
revised 14 May 2014

accepted 15 July 2014

Publication Date:
14 August 2014 (online)

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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
 

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