Clozapine Augmentation in Clozapine Resistant Schizophrenia – Quick Review – 2023 Update

Time to read: 10 minutes

Up to 30% of patients with schizophrenia are classed as non-responders to antipsychotics. [Hasan et al., 2012].

A recent international collaborative (Treatment-resistant schizophrenia: Treatment Response and Resistance in Psychosis (TRRIP)  has produced suggested treatment resistance criteria, summarised in the table below. [Howes et al., 2017]

There are three key tenets.

  1. Confirmed diagnosis – Schizophrenia was diagnosed using validated criteria, and the presence of co-morbidities was evaluated and taken into consideration.
  2. Adequate treatment – Sequential treatment with two different antipsychotics at the minimum effective dose over a duration of at least 6 weeks [NICE Guidelines 2014].
  3. Adherence – Persistence of symptoms despite treatment adherence; non-adherence is a significant issue, and therefore, at least one long-acting injectable formulation is required.