title: Non-glutamatergic clozapine augmentation strategies: a review and meta-analysis.
abstract: Persistent negative symptoms and cognitive impairment are major clinical problems in the treatment of schizophrenia. There is no convincing evidence regarding the efficacy of augmentation of clozapine with a second antipsychotic, ethyl eicosapentaenoic acid (E-EPA), an antidepressant, a mood stabilizer or extract of Ginkgo biloba in clozapine-resistant schizophrenia. We present an overview of studies in which the potential clinical utility of the addition of non-glutamatergic agents to clozapine is assessed. We performed a meta-analysis on the efficacy of both risperidone and aripiprazole compared to placebo. We compared the effects of the addition of a second antipsychotic or an antidepressant to clozapine on positive, negative, overall and affective symptoms of schizophrenia in double-blind placebo-controlled trials.
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, University Medical Center Utrecht, UMCU, Utrecht, The Netherlands.
authors.forename: M J H
authors.initials: MJ
authors.lastname: Begemann
authors.affiliation: Early Psychosis Department, AMC, Academic Psychiatric Centre, Amsterdam, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: de Haan
mesh_terms: D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D010054:Brief Psychiatric Rating Scale; D003024:Clozapine / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004361:Drug Tolerance; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D020441:Ginkgo biloba; D006801:Humans; D028321:Plant Preparations / Q000008:administration & dosage / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012559:Schizophrenia / Q000188:drug therapy
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D028321:Plant Preparations; C035276:eicosapentaenoic acid ethyl ester; D015118:Eicosapentaenoic Acid; D003024:Clozapine