PMID- 18562423 OWN - NLM STAT- MEDLINE DCOM- 20090709 LR - 20220317 IS - 0269-8811 (Print) IS - 0269-8811 (Linking) VI - 23 IP - 3 DP - 2009 May TI - Efficacy and tolerability of ziprasidone versus risperidone as augmentation in patients partially responsive to clozapine: a randomised controlled clinical trial. PG - 305-14 LID - 10.1177/0269881108089593 [doi] AB - Patients suffering from schizophrenic psychoses sometimes insufficiently respond to antipsychotic monotherapy and then combination approaches are preferred. We aimed in validating the add-on of ziprasidone and risperidone to clozapine, and we performed a randomised head-to-head trial. Patients with partial response to clozapine were randomly attributed to augmentation with ziprasidone (n = 12) or risperidone (n = 12). Efficacy assessments included the Positive and Negative Syndrome Scale (PANSS), the Scale for the Assessment of Negative Symptoms (SANS), the Hamilton Depression Scale (HAMD), the Clinical Global Impression (CGI) and the Global Assessment of Functioning (GAF). Furthermore, several safety and tolerability measures were obtained. After six weeks, both groups showed significant reductions of positive and negative symptoms. In addition, affective state, psychosocial functioning and clozapine side effects improved without significant differences between the groups. Both approaches were well tolerated. However, the ziprasidone group experienced a small elongation of the QTc interval and a reduction of extrapyramidal symptoms. Patients under clozapine-risperidone therapy developed a rise of serum prolactin levels. The clozapine augmentation with ziprasidone or risperidone resulted in significant psychopathological improvements. The side effects differed between the treatment groups. Further head-to-head comparisons of atypical antipsychotics as add-on to clozapine are necessary. FAU - Zink, Mathias AU - Zink M AD - Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany. mathias.zink@zi-mannheim.de FAU - Kuwilsky, A AU - Kuwilsky A FAU - Krumm, B AU - Krumm B FAU - Dressing, H AU - Dressing H LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20080618 PL - United States TA - J Psychopharmacol JT - Journal of psychopharmacology (Oxford, England) JID - 8907828 RN - 0 (Antipsychotic Agents) RN - 0 (Piperazines) RN - 0 (Thiazoles) RN - 6UKA5VEJ6X (ziprasidone) RN - 9002-62-4 (Prolactin) RN - J60AR2IKIC (Clozapine) RN - L6UH7ZF8HC (Risperidone) SB - IM MH - Adolescent MH - Adult MH - Antipsychotic Agents/adverse effects/*therapeutic use MH - Clozapine/adverse effects/therapeutic use MH - Drug Therapy, Combination MH - Female MH - Humans MH - Long QT Syndrome/chemically induced MH - Male MH - Middle Aged MH - Piperazines/adverse effects/*therapeutic use MH - Prolactin/blood/drug effects MH - Psychiatric Status Rating Scales MH - Risperidone/adverse effects/*therapeutic use MH - Schizophrenia/*drug therapy MH - Schizophrenic Psychology MH - Severity of Illness Index MH - Thiazoles/adverse effects/*therapeutic use MH - Treatment Outcome MH - Young Adult EDAT- 2008/06/20 09:00 MHDA- 2009/07/10 09:00 CRDT- 2008/06/20 09:00 PHST- 2008/06/20 09:00 [pubmed] PHST- 2009/07/10 09:00 [medline] PHST- 2008/06/20 09:00 [entrez] AID - 0269881108089593 [pii] AID - 10.1177/0269881108089593 [doi] PST - ppublish SO - J Psychopharmacol. 2009 May;23(3):305-14. doi: 10.1177/0269881108089593. Epub 2008 Jun 18.