Augmentation approaches in scizophrenic patients resistant to clozapine: A review
Akdag, HA (2010) Augmentation approaches in scizophrenic patients resistant to clozapine: A review. Anatolian Journal of Psychiatry (Anadolu Psikiyatri Dergisi), 11 (4). pp. 343-350.
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Clozapine is atypical antipsychotic whose efficacy in schizophrenic patients refractory to treatment has been proven. However, the proportion of patients diagnosed with schizophrenia and schizoeffective disorder and who do not respond to clozapine treatment is quite high, namely 40-70%. Therefore studies are carried out in order to develop new treatment approaches in scziophrenic patients resistant to clozapine treatment. The results of various studies carried out with various psychopharmological agents provide inconclusive evidence that treament options other than clozapine may be present. Given available information at present, it is not posssible to considere one drug superior to another and hence to discontinue clozapine, commence another psychotropic drug or to combine clozapine with another drug. However, according to the results of controlled studies or practice of clinicians, it is seen that augmentation approaches in addition to clozapine treatment are preferred. There are various approaches aiming to augmentation clozapine treatment such as atypical antipsyhotics, antidepressants, affective regulation agents, N,Methyl-d-aspartat (NMDA) receptor agonists. The aim of this article to guide clinicians in what psycholopharmocological approaches can be used in patients who do not respond to clozapin treatment or respond to it partially, which is regarded as optimal treatment approach in schizophrenic patients resistant to treatment. The purposes of the present article to rewiew avaible controlled studies, open studies anc case reports in literature about clozapine-resistant schizophrenic patients.
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