title: Lamotrigine augmentation in patients with schizophrenia who show partial response to clozapine treatment.
abstract: BACKGROUND
  Several placebo controlled studies investigating lamotrigine augmentation of clozapine in schizophrenia patients with partial response have shown varying results. The aim of this study was to further investigate the efficacy and safety of this augmentation strategy, and its effect on the glutamatergic system through utilizing mismatch negativity (MMN) component of auditory event related potentials.
  
  
  METHODS
  The study was designed to evaluate the efficacy and safety of lamotrigine augmentation of clozapine in a 12-week, double-blind, placebo-controlled, prospective, randomized design. Thirty-four patients diagnosed according to DSM-IV schizophrenia criteria and with partial response to clozapine were included. Patients were randomized to 25mg/day of lamotrigine or placebo, gradually increasing up to 200mg/day on the 6th week. The change in psychopathology was assessed with Positive and Negative Syndrome (PANSS), Calgary Depression (CDS) and Clinical Global Impression-Severity (CGI-S) scales. A neuropsychological test battery was administered and MMN measurements were also obtained at baseline and endpoint. Safety evaluation included physical examination, UKU Side Effect Rating Scale (UKU) assessment and serum drug level measurements.
  
  
  RESULTS
  No significant differences were found between the two treatment groups in PANSS Positive and General Psychopathology, CDS, neurocognitive test and UKU scores, as well as MMN measurements. PANSS Total, Negative and CGI-S scores showed significant improvement compared to lamotrigine in the placebo group.
  
  
  CONCLUSIONS
  This study did not show any benefit of augmentation of clozapine with lamotrigine in schizophrenia patients with partial response. The need for further investigation of other augmentation strategies of clozapine in partially responsive schizophrenia patients is evident.
authors.affiliation: Akçakale State Hospital, Psychiatry Clinic, Şanlıurfa, Turkey.
authors.forename: Sefa
authors.initials: S
authors.lastname: Vayısoğlu
authors.forename: A Elif
authors.initials: AE
authors.lastname: Anıl Yağcıoğlu
authors.forename: Süha
authors.initials: S
authors.lastname: Yağcıoğlu
authors.forename: Sevilay
authors.initials: S
authors.lastname: Karahan
authors.forename: Oğuzhan
authors.initials: O
authors.lastname: Karcı
authors.forename: S Can
authors.initials: SC
authors.lastname: Gürel
authors.forename: M Kâzım
authors.initials: MK
authors.lastname: Yazıcı
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D003024:Clozapine / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000188:drug therapy / Q000209:etiology; D004311:Double-Blind Method; D004357:Drug Synergism; D004569:Electroencephalography; D005072:Evoked Potentials, Auditory / Q000187:drug effects; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy*; D012720:Severity of Illness Index; D014227:Triazines / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D002121:Calcium Channel Blockers; D014227:Triazines; D003024:Clozapine; D000077213:Lamotrigine