Original Research

Amisulpride as adjunct to clozapine in treatment-resistant schizophrenia and schizoaffective disoder: An open-label pilot study

Liezl Koen, Dana J Niehaus, Angelica Schutte, Jacqueline Muller, Robin Emsley, Piet Oosthuizen
South African Journal of Psychiatry | Vol 12, No 1 | a49 | DOI: https://doi.org/10.4102/sajpsychiatry.v12i1.49 | © 2006 Liezl Koen, Dana J Niehaus, Angelica Schutte, Jacqueline Muller, Robin Emsley, Piet Oosthuizen | This work is licensed under CC Attribution 4.0
Submitted: 03 March 2008 | Published: 01 March 2006

About the author(s)

Liezl Koen, Department of Psychiatry, Stellenbosch University, Western Cape, South Africa
Dana J Niehaus, Department of Psychiatry, Stellenbosch University, Western Cape, South Africa
Angelica Schutte, Department of Psychiatry, Stellenbosch University, Western Cape
Jacqueline Muller, Department of Psychiatry, Stellenbosch University, Western Cape
Robin Emsley, Department of Psychiatry, Stellenbosch University, Western Cape
Piet Oosthuizen, Department of Psychiatry, Stellenbosch University, Western Cape

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Abstract

Background. Although clozapine is the treatment of choice for treatment-resistant schizophrenia, many patients remain symptomatic despite adequate treatment with this medication. One suggested strategy to improve efficacy has been the addition of a potent D2 blocker such as amisulpride to treatment with clozapine.

Methods. In this study, 20 subjects who were treatment-resistant to conventional antipsychotics and who were still symptomatic despite adequate treatment with clozapine received amisulpride as adjunctive treatment. After baseline assessment all subjects were titrated to amisulpride 400 mg per day and then reassessed after 8 weeks by a blinded rater.

Results. Analysis showed statistically significant improvements in PANSS (Positive and Negative Symptom Scale) total score (t = 3.49, df = 18, p = 0.003), PANSS negative subscale score (t = 3.22, df = 18, p = 0.005), and PANSS depression factor score (t = 3.89, df = 19, p = 0.001).

Discussion. This study suggests that addition of the second- generation antipsychotic amisulpride to a stable treatment regimen with clozapine may offer additional benefits in terms of negative and depressive symptoms.


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