When clozapine fails: Augmentation strategies in the management of clozapine-resistant schizophrenia

Domenico De Berardis; Michele Fornaro; Annalisa Anastasia; Federica Vellante; Alessandro Valchera; Marilde Cavuto; Giampaolo Perna; Marco Di Nicola; Gianluca Serafini; Alessandro Carano; Maurizio Pompili; Laura Orsolini; Carmine Tomasetti; Gabriella Di Emidio; Giovanni Martinotti; Massimo Di Giannantonio

doi:10.1007/978-981-10-4358-1_23

When clozapine fails: Augmentation strategies in the management of clozapine-resistant schizophrenia

Domenico De Berardis^*, Michele Fornaro, Annalisa Anastasia, Federica Vellante, Alessandro Valchera, Marilde Cavuto, Giampaolo Perna, Marco Di Nicola, Gianluca Serafini, Alessandro Carano, Maurizio Pompili, Laura Orsolini, Carmine Tomasetti, Gabriella Di Emidio, Giovanni Martinotti, Massimo Di Giannantonio

^*Corresponding author for this work

MHeNs - Mental Health

Research output: Chapter in Book/Report/Conference proceeding › Chapter › Academic

Abstract

Schizophrenia is a chronic and debilitating illness affecting about 0.5% of the population. Antipsychotics are the mainstay of the pharmacological treatment of such burdensome condition, although documented that roughly 20% up to 60% of the patients with schizophrenia do not respond sufficiently to conventional treatments. These patients may have a good response when clozapine is introduced with a great efficacy often seen in everyday clinical practice. However, it has been estimated that around 40-70% of patients with ascertained treatment-resistant schizophrenia receiving clozapine may have an incomplete remission and are referred to as “ultra-resistant” or “refractory.” Clozapine-resistant schizophrenia represents a challenge for the clinician and a misfortune for the patients, and several strategies have been proposed to overcome this problem, yet, to date, it remains high-bar goal. The aim of this chapter was to provide an overview of the managing strategies of clozapine-resistant schizophrenia with a particular focus on augmentation strategies aimed to improve efficacy on schizophrenia symptoms.

Original language	English
Title of host publication	Treatment Resistance in Psychiatry: Risk Factors, Biology, and Management
Editors	Yong-Ku Kim
Publisher	Springer Singapore
Pages	349-367
Number of pages	19
ISBN (Electronic)	9789811043581
ISBN (Print)	9789811043574
DOIs	https://doi.org/10.1007/978-981-10-4358-1_23
Publication status	Published - 1 Jan 2018

Keywords

Add-on
Augmentation
Clozapine
Efficacy
Refractory
Tolerability
Ultra-resistant

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10.1007/978-981-10-4358-1_23

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De Berardis, D., Fornaro, M., Anastasia, A., Vellante, F., Valchera, A., Cavuto, M., Perna, G., Di Nicola, M., Serafini, G., Carano, A., Pompili, M., Orsolini, L., Tomasetti, C., Di Emidio, G., Martinotti, G., & Di Giannantonio, M. (2018). When clozapine fails: Augmentation strategies in the management of clozapine-resistant schizophrenia. In Y.-K. Kim (Ed.), Treatment Resistance in Psychiatry: Risk Factors, Biology, and Management (pp. 349-367). Springer Singapore. https://doi.org/10.1007/978-981-10-4358-1_23

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title = "When clozapine fails: Augmentation strategies in the management of clozapine-resistant schizophrenia",

abstract = "Schizophrenia is a chronic and debilitating illness affecting about 0.5% of the population. Antipsychotics are the mainstay of the pharmacological treatment of such burdensome condition, although documented that roughly 20% up to 60% of the patients with schizophrenia do not respond sufficiently to conventional treatments. These patients may have a good response when clozapine is introduced with a great efficacy often seen in everyday clinical practice. However, it has been estimated that around 40-70% of patients with ascertained treatment-resistant schizophrenia receiving clozapine may have an incomplete remission and are referred to as “ultra-resistant” or “refractory.” Clozapine-resistant schizophrenia represents a challenge for the clinician and a misfortune for the patients, and several strategies have been proposed to overcome this problem, yet, to date, it remains high-bar goal. The aim of this chapter was to provide an overview of the managing strategies of clozapine-resistant schizophrenia with a particular focus on augmentation strategies aimed to improve efficacy on schizophrenia symptoms.",

keywords = "Add-on, Augmentation, Clozapine, Efficacy, Refractory, Tolerability, Ultra-resistant",

author = "{De Berardis}, Domenico and Michele Fornaro and Annalisa Anastasia and Federica Vellante and Alessandro Valchera and Marilde Cavuto and Giampaolo Perna and {Di Nicola}, Marco and Gianluca Serafini and Alessandro Carano and Maurizio Pompili and Laura Orsolini and Carmine Tomasetti and {Di Emidio}, Gabriella and Giovanni Martinotti and {Di Giannantonio}, Massimo",

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doi = "10.1007/978-981-10-4358-1_23",

language = "English",

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De Berardis, D, Fornaro, M, Anastasia, A, Vellante, F, Valchera, A, Cavuto, M, Perna, G, Di Nicola, M, Serafini, G, Carano, A, Pompili, M, Orsolini, L, Tomasetti, C, Di Emidio, G, Martinotti, G & Di Giannantonio, M 2018, When clozapine fails: Augmentation strategies in the management of clozapine-resistant schizophrenia. in Y-K Kim (ed.), Treatment Resistance in Psychiatry: Risk Factors, Biology, and Management. Springer Singapore, pp. 349-367. https://doi.org/10.1007/978-981-10-4358-1_23

When clozapine fails: Augmentation strategies in the management of clozapine-resistant schizophrenia. / De Berardis, Domenico; Fornaro, Michele; Anastasia, Annalisa et al.
Treatment Resistance in Psychiatry: Risk Factors, Biology, and Management. ed. / Yong-Ku Kim. Springer Singapore, 2018. p. 349-367.

Research output: Chapter in Book/Report/Conference proceeding › Chapter › Academic

TY - CHAP

T1 - When clozapine fails

T2 - Augmentation strategies in the management of clozapine-resistant schizophrenia

AU - De Berardis, Domenico

AU - Fornaro, Michele

AU - Anastasia, Annalisa

AU - Vellante, Federica

AU - Valchera, Alessandro

AU - Cavuto, Marilde

AU - Perna, Giampaolo

AU - Di Nicola, Marco

AU - Serafini, Gianluca

AU - Carano, Alessandro

AU - Pompili, Maurizio

AU - Orsolini, Laura

AU - Tomasetti, Carmine

AU - Di Emidio, Gabriella

AU - Martinotti, Giovanni

AU - Di Giannantonio, Massimo

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Schizophrenia is a chronic and debilitating illness affecting about 0.5% of the population. Antipsychotics are the mainstay of the pharmacological treatment of such burdensome condition, although documented that roughly 20% up to 60% of the patients with schizophrenia do not respond sufficiently to conventional treatments. These patients may have a good response when clozapine is introduced with a great efficacy often seen in everyday clinical practice. However, it has been estimated that around 40-70% of patients with ascertained treatment-resistant schizophrenia receiving clozapine may have an incomplete remission and are referred to as “ultra-resistant” or “refractory.” Clozapine-resistant schizophrenia represents a challenge for the clinician and a misfortune for the patients, and several strategies have been proposed to overcome this problem, yet, to date, it remains high-bar goal. The aim of this chapter was to provide an overview of the managing strategies of clozapine-resistant schizophrenia with a particular focus on augmentation strategies aimed to improve efficacy on schizophrenia symptoms.

AB - Schizophrenia is a chronic and debilitating illness affecting about 0.5% of the population. Antipsychotics are the mainstay of the pharmacological treatment of such burdensome condition, although documented that roughly 20% up to 60% of the patients with schizophrenia do not respond sufficiently to conventional treatments. These patients may have a good response when clozapine is introduced with a great efficacy often seen in everyday clinical practice. However, it has been estimated that around 40-70% of patients with ascertained treatment-resistant schizophrenia receiving clozapine may have an incomplete remission and are referred to as “ultra-resistant” or “refractory.” Clozapine-resistant schizophrenia represents a challenge for the clinician and a misfortune for the patients, and several strategies have been proposed to overcome this problem, yet, to date, it remains high-bar goal. The aim of this chapter was to provide an overview of the managing strategies of clozapine-resistant schizophrenia with a particular focus on augmentation strategies aimed to improve efficacy on schizophrenia symptoms.

KW - Add-on

KW - Augmentation

KW - Clozapine

KW - Efficacy

KW - Refractory

KW - Tolerability

KW - Ultra-resistant

U2 - 10.1007/978-981-10-4358-1_23

DO - 10.1007/978-981-10-4358-1_23

M3 - Chapter

SN - 9789811043574

SP - 349

EP - 367

BT - Treatment Resistance in Psychiatry: Risk Factors, Biology, and Management

A2 - Kim, Yong-Ku

PB - Springer Singapore

ER -

When clozapine fails: Augmentation strategies in the management of clozapine-resistant schizophrenia

Abstract

Keywords

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