[Ziprasidone-augmentation of clozapine].
OBJECTIVE
In cases of treatment-resistant schizophrenic psychoses combined application of atypical antipsychotic drugs is an often-used strategy.


METHODS
We report the case of a 35-year old man with paranoid schizophrenia, whose symptoms turned out to be resistant to the application of olanzapine, risperidone and quetiapine. After switch to clozapine paranoid delusions remitted, but schizophrenic negative symptoms persisted and side effects limited the patient's compliance. Augmentation with ziprasidone allowed a reduction of the clozapine dose and ameliorated the affective deficits.


RESULTS
Positive and negative symptoms were well controlled. In spite of a transient hyperprolactinaemia and sexual dysfunction the patient was highly content.


CONCLUSIONS
The combined application of ziprasidone and clozapine follows a neurobiological rationale, seems able to reduce side effects, and should be further evaluated with respect to risk and benefit in prospective studies.
Zink
Mathias
M
Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, Mannheim. zink@kv.zi-mannheim.de
Mase
Evelyn
E
Dressing
Harald
H
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003024:Clozapine / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D006966:Hyperprolactinemia / Q000097:blood / Q000139:chemically induced; D008297:Male; D010879:Piperazines / Q000008:administration & dosage* / Q000009:adverse effects; D011388:Prolactin / Q000097:blood; D011569:Psychiatric Status Rating Scales; D012563:Schizophrenia, Paranoid / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D013844:Thiazoles / Q000008:administration & dosage* / Q000009:adverse effects
D014150:Antipsychotic Agents; D010879:Piperazines; D013844:Thiazoles; C092292:ziprasidone; D011388:Prolactin; D005640:Follicle Stimulating Hormone; D003024:Clozapine