title: Combination of clozapine and ziprasidone in treatment-resistant schizophrenia: an open clinical study.
abstract: OBJECTIVE
  Therapeutic options for patients with treatment-resistant schizophrenia are limited. In such patients, combined application of atypical antipsychotic drugs is an often-used strategy. The authors tested the hypothesis that the combination of ziprasidone and clozapine would lead to an improvement in this patient group.
  
  
  METHODS
  Nine patients with treatment-resistant schizophrenia participated in this open clinical trial and received a combination regimen of ziprasidone and clozapine. Patients had to have remained on a stable dose of clozapine for at least 6 months to ensure a reasonable opportunity to respond to clozapine monotherapy. Clinical status was evaluated at baseline, and at 3 and 6 months' follow-up using the Brief Psychiatric Rating Scale (BPRS).
  
  
  RESULTS
  All patients completed the 6-month combination treatment. The mental state of 7 patients (77.8%) was improved and there was a significant reduction in the mean BPRS score over the 6 months treatment. The coadministration of ziprasidone in clozapine-treated patients did not result in a corresponding increase in side effects. The combination allowed a 18% reduction of the daily clozapine dose.
  
  
  CONCLUSIONS
  The combined application of clozapine and ziprasidone follows a neurobiologic rationale and appears to be safe and well tolerated without increasing the risk of side effects.
authors.affiliation: Department of Social Psychiatry and Psychotherapy, Hanover Medical School (MHH), Hannover, Germany. ziegenbein.marc@mh-hannover.de
authors.forename: Marc
authors.initials: M
authors.lastname: Ziegenbein
authors.forename: Stefan
authors.initials: S
authors.lastname: Kropp
authors.forename: Heike E
authors.initials: HE
authors.lastname: Kuenzel
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003024:Clozapine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D013844:Thiazoles / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D010879:Piperazines; D013844:Thiazoles; C092292:ziprasidone; D003024:Clozapine