Effect of aripiprazole augmentation of clozapine in schizophrenia: a double-blind, placebo-controlled study.

Muscatello MRA, Bruno A, Pandolfo G, Micò U, Scimeca G, Di Nardo F, et al.. Effect of aripiprazole augmentation of clozapine in schizophrenia: a double-blind, placebo-controlled study. Schizophrenia Res. 2011;127(1-3):93-9. DOI: 10.1016/j.schres.2010.12.011. PubMed PMID: 21262565.

Iloperidone in the Treatment of Seriously Mentally Ill Patients with Treatment-Refractory Schizophrenia and Schizoaffective Disorder: A Case Series

Iloperidone (Fanapt®) is a new antipsychotic approved for the treatment of acute schizophrenia. Until now, there are no reports of the use of iloperidone in treatment-refractory psychotic patients. This report summarized our first seven severely mentally ill patients with treatment-refractory schizophrenia and schizoaffective disorder treated with iloperidone.

Assessment of Prophylactic Clozapine Levels in Stable Outpatients with Schizophrenia and Schizoaffective Disorder

While schizophrenia affects an estimated 1% of the population, its treatment consumes approximately 2.5% of annual health care expenditures. Hospitalization of schizophrenic patients is often due to ineffectiveness of or noncompliance with pharmacological treatment. Clozapine is generally considered the most effective antipsychotic medication, but its use is limited due to the potential for serious side effects such as agranulocytosis, weight gain, seizures, and metabolic disturbances. The metabolism of clozapine is affected by individual patient factors, including ethnicity, smoking, and concomitant medications that induce or inhibit cytochrome P450 1A2. Widely variable plasma clozapine concentrations may lead to treatment failure or toxicity. These complications may be avoided if validated clozapine plasma concentrations were established and implemented in the stable outpatient population. This study will compare clozapine blood levels attained in a stable, outpatient population to individual response measured by a validated psychiatric rating scale.

Antipsychotic Treatment and Tobacco Craving in People With Schizophrenia

Nicotine dependence is high in people with schizophrenia and about three times more prevalent than the general population. Nicotine mediates reinforcement from smoking via dopamine which may impact nicotine craving. Antipsychotics block dopamine, thereby potentially affecting craving and/or smoking behavior.

The presynaptic component of the serotonergic system is required for clozapine's efficacy.

Yadav PN, Abbas AI, Farrell MS, Setola V, Sciaky N, Huang X-P, et al. The presynaptic component of the serotonergic system is required for clozapine's efficacy. Neuropsychopharmacology. 2011;36(3):638-51. DOI: 10.1038/npp.2010.195. PubMed PMID: 21048700; PubMed Central PMCID: PMC3055689.


Point of Care Testing (POCT) is a safe and effective tool for routinely monitoring patients taking clozapine. The burden of clozapine monitoring impacts a patients and prescribers willingness to prescribe clozapine. Horiba® desk top hematology analyzer provides a 16 parameter histogram and is intended for use in clinical laboratories and small clinics. POCT solves many of the problems with clozapine monitoring. POCT can eliminate the anxiety of a venipuncture and only requires a small amount of capillary blood.

Comparison of hospitalisation time of schizophrenic patients exposed and not exposed to therapeutic drug monitoring of clozapine

Clozapine is the most effective antipsychotic drug for the treatment of schizophrenia, but unfortunately its safety profile constrains it to last resort treatment. Moreover, this cul-de-sac is filled with obstacles that make clozapine the most challenging psychotropic drug to prescribe. Hopefully, optimisation of clozapine treatment can be achieved in multiple ways, one of which is therapeutic drug monitoring (TDM). Multiple studies have shown a link between a clozapine blood concentration threshold of 350 ng/mL and improved clinical response. However, no research has been done on the effectiveness of TDM as a tool to optimize clozapine treatment. Our hypothesis was that TDM could shorten clozapine titration time, thereby decreasing hospitalisation length.

Evaluating the Effect of Concomitant Medications With Clozapine

This study replicated and expanded a previous retrospective chart review conducted at Buffalo Psychiatric Center examining the impact of medication co-administration with clozapine patients for a significantly larger sample. Assuring the proper identification of problematic medication combinations with clozapine may minimize interruption/cessation of clozapine therapy.

A Cross Country Study of The Effect of Three Dibenzodiazepines: Clozapine, Quetiapine And Olanzepine On Thyroid Function In Patients With Schizophrenia

Thyroid function is very important in psychiatric disorders. Thyroid plays very important role in disease states such as schizophrenia and mood disorders. Atypical antipsychotics including dibenzodiazepines class often used as the first line agent to treat schizophrenia or schizoaffective disorders. Based on several case reports, clozapine, quetiapine and olanzepine are found to decrease thyroid hormone, TT4, FT4 and FT3. This can complicate psychiatric treatment regimen and delay the disease recovery process.