title: Clozapine augmented with glutamate modulators in refractory schizophrenia: a review and metaanalysis.
abstract: Clozapine is an efficacious antipsychotic drug for patients with treatment-resistant schizophrenia, but does not sufficiently improve these symptoms in a substantial proportion of this population. There is no convincing evidence for the efficacy of any clozapine augmentation strategy. New evidence suggests that glutamate receptors are a candidate target for therapeutic effects in schizophrenia. We present an overview of studies assessing the potential clinical utility of adding glutamatergic agents to clozapine. We conducted 3 metaanalyses of data on positive, negative and overall symptoms of schizophrenia, analysing results from 3 studies on clozapine augmentation with glycine, 6 studies on lamotrigine add-on therapy to clozapine and 4 studies on topiramate addition to clozapine.
authors.affiliation: Flexible Assertive Community Treatment, Mental Health Service -Organisation North Holland North, Community Mental Health Division, Alkmaar, The Netherlands.
authors.forename: S R T
authors.initials: SR
authors.lastname: Veerman
authors.affiliation: Treatment Centre for Bipolar Disorders, Mental Health Service -Organisation North Holland North, Division for Specialised Treatment, Alkmaar, The Netherlands.
authors.forename: P F J
authors.initials: PF
authors.lastname: Schulte
authors.affiliation: Neuroscience Department & Rudolf Magnus Institute for Neuroscience, UMCU, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: M J H
authors.initials: MJ
authors.lastname: Begemann
authors.affiliation: Research Department, Mental Health Service Organisation North Holland North, Heerhugowaard, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Engelsbel
authors.affiliation: Early Psychosis Department, AMC, Academic Psychiatric Centre, -Amsterdam, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: de Haan
mesh_terms: D000818:Animals; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003024:Clozapine / Q000627:therapeutic use*; D004357:Drug Synergism; D018683:Excitatory Amino Acid Agents / Q000627:therapeutic use*; D018698:Glutamic Acid / Q000378:metabolism*; D006801:Humans; D012559:Schizophrenia / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D018683:Excitatory Amino Acid Agents; D018698:Glutamic Acid; D003024:Clozapine