2005 issue 4


Volume 14, issue 4

Review article

When clozapine is not enough

1. III Klinika Psychiatryczna Instytutu Psychiatrii i Neurologii w Warszawie
Postępy Psychiatrii i Neurologii 2005; 14 (4): 352-336
Keywords: clozapine, augmentation


Objectives. An attempt was made in the paper to overview methods most frequently used in cases of a clozapine treatment failure.

Background. The problem of resistance to clozapine treatment is discussed. Since these severely ill patients require treatment and there are neither any algorithms nor clear-cut recommendations available, clinical practitioners are frequently forced to use various therapeutic innovations. First and foremost they try the treatment optimization, and if that fails, attempts are made at the clozapine therapeutic effect augmentation by simultaneous administration of another neuroleptic, a normothymic medication, benzodiazepine, an antidepressant, NMDA receptor agonist, or electroconvulsive therapy.

Conclusions. There is no univocal evidence for any single augmentation strategy superiority over other ones. Thus, data presented in the paper are not a therapeutic prescription, but rather a review ofpossible solutions in this area, of their respective benefits and associated side effects.

Address for correspondence:
Dr Marek Grochowski, III Klinika Psychiatryczna Instytutu Psychiatrii i Neurologii, ul. Sobieskiego 9, 02-957 Warszawa, e-mail: grochows@ipin.edu.pl