title: Is clozapine-aripiprazole combination a useful regime in the management of treatment-resistant schizophrenia?
abstract: Around 40-70% patients with treatment-resistant schizophrenia fail to respond to clozapine. Though combining antipsychotics is commonly practised with non-responders, there is little evidence for its use.We carried out a retrospective review of case notes of patients with treatment-resistant schizophrenia on clozapine-aripiprazole combination at our clozapine clinic. We report changes in psychotic symptoms, social function, weight, total cholesterol, serum glucose, HDL, CGI and GAF score pre- and post-aripiprazole augmentation. Clozapine-aripiprazole combination was associated with 22% reduction of clozapine dose. Eighteen out of 24 (75%) lost a mean weight of 5.05 kg. There was improvement in positive and negative symptoms, social functions, weight loss and a moderate increase in HDL. Our findings suggest that clozapine-aripiprazole is a safe and tolerable combination; however, control trials are needed to validate our findings.
authors.affiliation: North East Wales NHS Trust, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham, UK.
authors.forename: Kanapathippillai
authors.initials: K
authors.lastname: Karunakaran
authors.forename: Tongeji E
authors.initials: TE
authors.lastname: Tungaraza
authors.forename: Giles C
authors.initials: GC
authors.lastname: Harborne
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000068180:Aripiprazole; D001786:Blood Glucose / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D002784:Cholesterol / Q000097:blood; D003024:Clozapine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D010879:Piperazines / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D015363:Quinolones / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy* / Q000503:physiopathology; D012565:Schizophrenic Psychology
chemical_list: D014150:Antipsychotic Agents; D001786:Blood Glucose; D010879:Piperazines; D015363:Quinolones; D000068180:Aripiprazole; D002784:Cholesterol; D003024:Clozapine