Journals / Nöropsikiyatri Arşivi / 2010 / Cilt: 47 - Sayı: 1

Augmentation of clozapine with pimozide: A case of a treatment-resistant schizophrenic patient

Klozapin tedavisini pimozid ile güçlendirme yaklaşımı: Tedaviye dirençli bir şizofreni olgusu

Pages
74–77
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The presented history reveals that only the combination of clozapine with pimozide was beneficial for this particular patient, whose symptoms relapsed after the cessation of the drugs, and who apparently benefited from treatment when this combination was initiated again.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:In the treatment of resistant schizophrenic patients, the preferred monotherapy of clozapine, does not result in sufficient treatment response in 40-70% of the cases.
📊
Key Findings & Data:The high rate of treatment unresponsiveness has led clinicians to augment clozapine with other pharmacological agents.
💡
Conclusion & Impact:The presented history reveals that only the combination of clozapine with pimozide was beneficial for this particular patient, whose symptoms relapsed after the cessation of the drugs, and who apparently benefited from treatment when this combination was initiated again.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

In the treatment of resistant schizophrenic patients, the preferred monotherapy of clozapine, does not result in sufficient treatment response in 40-70% of the cases. The high rate of treatment unresponsiveness has led clinicians to augment clozapine with other pharmacological agents. To date, many clinical and case studies have been conducted. In related studies, clozapine has been combined with various drugs, such as typical and atypical antipsychotics, several antidepressants, mood stabilizers, bromocriptine and glycine. However, up-to-date research study results are not sufficient to support the augmentation of clozapine therapy approaches. The augmentation of clozapine with pimozide has been a rarely preferred approach. In this paper, a case of a patient is presented, who was followed with the diagnosis of treatment-resistant disorganized schizophrenia and whose clozapine treatment was augmented with pimozide. The presented history reveals that only the combination of clozapine with pimozide was beneficial for this particular patient, whose symptoms relapsed after the cessation of the drugs, and who apparently benefited from treatment when this combination was initiated again.

Özet

Tedaviye dirençli şizofreni hastalarında monoterapide tercih edilen klozapin tedavisine % 40-70 oranında yeterli yanıt alınamamaktadır. Bu yüksek oranlarda bildirilen tedavi yanıtsızlığı klinisyenleri klozapini diğer farmakolojik ajanlarla güçlendirme yaklaşımlarına yönlendirmiştir. Bu amaçla yapılan çalışmalarda klozapin tipik ve atipik antipsikotikler, çeşitli antidepresanlar, duygu durum düzenleyiciler, bromokriptin ve glisin gibi ilaçlarla kombine edilmiştir. Ancak günümüze kadar yapılan çalışmaların sonuçları klozapin tedavisini güçlendirme yaklaşımlarını bilimsel anlamda desteklemek için henüz yeterli değildir. Klozapin tedavisini pimozid ile güçlendirme yaklaşımı nadiren de olsa literatürde tercih edilen bir tedavi olmuştur. Bu yazıda tedaviye dirençli dezorganize şizofreni tanısıyla takip edilen ve öyküsünde sadece klozapin ve pimozid kombinasyonundan fayda gören, ilaç kesilmesi sonrası psikotik belirtileri alevlenen ve tekrar bu kombinasyon başlandığında tedaviye belirgin iyi yanıt veren bir olguyu sunuyoruz.

🔖

Cite This Article

AKDAĞ, A. H., KISA, C., BEKKİ, G., GÖKA, E. (2010). Augmentation of clozapine with pimozide: A case of a treatment-resistant schizophrenic patient. Nöropsikiyatri Arşivi, Cilt: 47 - Sayı: 1, 74–77. https://ajindex.com/articles/292657

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (16)

  1. Conley RR, Kelly DL. Management of treatment resistance in schizophrenia. Biol Psychiatry 2001; 50:898-911
  2. Elkis H, Meltzer HY. Refractory schizophrenia. Rev Bras Psiquiatr 2007; 29:541-7
  3. Miller AL, Hall CS, Buchanan RW et al. The Texas Medication Algorithm Project antipsychotic algorithm for schizophrenia: 2003 update. J Clin Psychiatry 2004; 65:500-8
  4. Buckley PF, Shendarkar N. Treatment-refractory schizophrenia. Curr Opin Psychiatry 2005; 18:165-73
  5. Kontaxakis VP, Ferentinas PP, Havaki-Kontaxaki BJ et al. Randomized controlled augmentation trials in clozapine-resistant schizophrenic patients; a critical review. European Psychiatry 2005; 20:409-15
  6. Zink M, Dressing H. Augmentation of clozapine with atypical antipsychotic substances. Curr Psychiatry Rev 2005; 1:165-72
  7. Anıl E, Turgut İT, Rezaki M ve ark. Klozapin Tedavisini Güçlendirme: Bir Gözden Geçirme. Türk Psikiyatri Dergisi 2002; 13:65-77
  8. Buchanan RW, Kirkpatrick B, Bryan N et al. Fluoxetine augmentation of clozapine treatment in patient with schizophrenia. Am J Psychiatry 1996; 153:1625-7
  9. Lerma-Carillo I, Molina JD, Cuevas-Duran T et al. Adjunctive treatment with risperidone in clozapine-resistant schizophrenia. Clin Neuropharmacology 2007; 30:114-21
  10. Kontaxakis VP, Ferentinas PP, Havaki-Kontaxaki BJ et al. Risperidone augmentation of clozapine. Eur Arch Psychiatry Clin Neurosci 2006; 256:350-5
  11. Josiassen RC, Joseph A, Kohegyi E et al. Clozapine augmented with risperidone in the treatment of schizophrenia: a randomized, double-blind, plasebo-controlled trial. Am J Psychiatry 2005; 162:130-6
  12. Anıl Yagcioglu AE, Kivircik Akdede BB, Turgut TI et al. A double-blind controlled study of adjunctive treatment with risperidone in schizophrenic patients partially responsive to clozapine: efficacy and safety. J Clin Psychiatry 2005; 66:63-72
  13. Freudenreich O, Henderson DC, Walsh JP. Risperidone augmentation for schizophrenia partially responsive to clozapine: A double blind, plasebo-controlled trial. Schizophr Res 2007; 92:90-4
  14. Shiloh R, Zemishiany Z, Aizenberg D et al. Sulpiride augmentation in people with schizophrenia partially responsive to clozapine. A double-blind, plasebo controlled study. Br J Psychiatry 1997; 171:569-73
  15. Leucht S, Kissling W, McGrath J. Lithium for schizophrenia revisited: a systematic review and meta-analysis of randomized controlled trials. J Clin Psychiatry 2004; 65:177-86
  16. Small JG, Klapper MH, Malloy FW et al. Tolerabilit