Risperidone augmentation for schizophrenia partially responsive to clozapine: a double-blind, placebo-controlled trial.
BACKGROUND
Risperidone augmentation of clozapine in refractory schizophrenia has theoretical but only inconsistent support from clinical trials.


OBJECTIVE
To examine if adding risperidone to stable yet symptomatic schizophrenia outpatients on optimized clozapine monotherapy improves psychopathology.


METHODS
We conducted a double-blind placebo-controlled parallel-group trial of a fixed dose of 4 mg/day risperidone added for 6 weeks in 24 outpatients with schizophrenia.


RESULTS
Subjects who received risperidone showed a non-significant decrease in PANSS total score. The PANSS disorganized thought subscale improved significantly (beta=-3.3079, p=0.047).


CONCLUSIONS
Our trial does not support the routine addition of risperidone to clozapine in refractory schizophrenia patients. However, much larger trials are needed to conclusively settle the question of added efficacy from this combination.
Freudenreich
Oliver
O
Massachusetts General Hospital Schizophrenia Program, Freedom Trail Clinic, 25 Staniford St., 2nd Floor, Boston, MA 02114, USA. ofreudenreich@partners.org
Henderson
David C
DC
Walsh
Jared P
JP
Culhane
Melissa A
MA
Goff
Donald C
DC
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003024:Clozapine / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011388:Prolactin / Q000097:blood; D018967:Risperidone / Q000008:administration & dosage / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy*
D014150:Antipsychotic Agents; D011388:Prolactin; D003024:Clozapine; D018967:Risperidone