Efficacy of pimozide augmentation for clozapine partial responders with
schizophrenia.
Author(s): Gunduz-Bruce H(1), Oliver S, Gueorguieva R, Forselius-Bielen K, D'Souza DC,
Zimolo Z, Tek C, Kaliora S, Ray S, Petrides G.
Affiliation(s): Author information:
(1)Yale School of Medicine, Department of Psychiatry, 300 George Street, New Haven,
CT 06510, United States. Handan.gunduz-bruce@yale.edu
Publication date & source: 2013, Schizophr Res. , 143(2-3):344-7
INTRODUCTION: A substantial number of patients with treatment-resistant
schizophrenia respond only partially to clozapine. Therefore, it has been common
practice to use augmentation strategies to maximize clozapine's effect. But the
efficacy of this strategy remains poorly established. We have conducted a
randomized double-blind placebo controlled clinical trial in patients with
schizophrenia currently receiving clozapine with partial response, and tested the
efficacy of pimozide augmentation on positive and negative symptoms and also on
neurocognitive measures.
METHODS: Thirty-two outpatients enrolled in the clinical trial and 28 completed.
Patients with adequate blood levels of clozapine were randomized to pimozide vs
placebo and participated in the trial for 12 weeks receiving monthly assessments
for Brief Psychiatric Rating Scale (BPRS) and Schedule for Assessment of Negative
Symptoms (SANS), and weekly assessments for electrocardiogram (EKG), and side
effects. Neurocognitive tests measuring verbal fluency, working memory, motor and
attention/executive function were obtained at study entry and end of the trial.
RESULTS: We found no significant effect of pimozide on BPRS total, psychosis and
depression subscale items, SANS scores or QTc interval. Neurocognitive measures
did not show significant improvement either.
DISCUSSION: In this well controlled clinical trial of patients with
treatment-resistant schizophrenia currently receiving clozapine, pimozide
augmentation was not an effective strategy to maximize the benefit for better
control of positive and negative symptoms or improving neurocognitive function.
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