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Refractory schizophrenia: adding aripiprazole to clozapine reduces negative but not overall symptoms

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QUESTION

Question:

Does aripiprazole improve the antipsychotic effect of clozapine without increasing the risk of major adverse events in people with refractory schizophrenia?

Patients:

61 Korean people, aged 18–65 years, with DSM-IV schizophrenia, a history of treatment failure, partial responsiveness to long term clozapine therapy (⩾1 year) and taking a stable clozapine dose for at least 3 months. Treatment failure was defined as persistent psychotic symptoms after at least two different antipsychotics at equivalent to ⩾600 mg/day chlorpromazine for ⩾6 weeks. Participants had to have a Brief Psychiatric Rating Scale (BPRS) score of ⩾35 or >2 global rating items on the Schedule for Assessment of Negative Symptoms (SANS) score ⩾3 (see online notes for exclusion criteria).

Setting:

Refractory Schizophrenia Clinic, Seoul National University, Republic of Korea. Recruitment 1 December 2005 to 10 December 2006.

Intervention:

Aripiprazole (5–30 mg/day) or placebo for 8 weeks. An initial dose of 5 mg/day aripiprazole was administered and increased to 10 mg/day at 1 week. If …

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