Speaker(s):
Presentation: Clozapine has been widely accepted as the most effective treatment for schizophrenia, refractory to other anti-psychotic drugs, which comprise of about 25% to 30% of patient population. However, a significant portion, 45 to 70%, of Clozapine-treated patients show a partial or inadequate response to treatment. There is scarcity of established evidence to guide clozapine-resistant psychosis in patients with schizophrenia. Several augmentation strategies including addition of another antipsychotic, mood stabilizers, anxiolytics, antidepressants, and glutamatergic agents, have failed to demonstrate convincing efficacy. Some data suggested promising efficacy of adjunctive ECT, however its clinical application cannot be generalized. The treatment of this subgroup of patients remains a major challenge, with increased health care costs and poor quality of life for affected individuals. Loxapine, a mid-potency first generation anti-psychotic, which has serotonin antagonism at lower doses, could be an effective adjunctive treatment for such patients, based upon literature. This presentation cites one of such patients who showed significant clinical improvement on combination of Clozapine and Loxapine, as evident by Global Clinical Impression, BPRS scores, group attendance, and self-care.
Objectives:
- Identify treatment resistant schizophrenia
- Define the role of Clozapine in treatment resistant schizophrenia
- Provide current data on alternative treatments for the Clozapine resistant schizophrenia
- Describe efficacy of adjunctive Loxapine in Clozapine resistant schizophrenia