Schizophrenia Research
Volume 92, Issue 1 , Pages 90-94, May 2007

Risperidone augmentation for schizophrenia partially responsive to clozapine: A double-blind, placebo-controlled trial

  • Oliver Freudenreich

      Affiliations

    • Massachusetts General Hospital Schizophrenia Program, Freedom Trail Clinic, 25 Staniford St., 2nd Floor, Boston, MA 02114, United States
    • Harvard Medical School, Boston, MA, United States
    • Boston University School of Medicine, Boston, MA, United States
    • Corresponding Author InformationCorresponding author. MGH Schizophrenia Program, Freedom Trail Clinic, 25 Staniford St., 2nd Floor, Boston, MA 02114, United States. Tel.: +1 617 912 7835; fax: +1 617 723 3919.
  • ,
  • David C. Henderson

      Affiliations

    • Massachusetts General Hospital Schizophrenia Program, Freedom Trail Clinic, 25 Staniford St., 2nd Floor, Boston, MA 02114, United States
    • Harvard Medical School, Boston, MA, United States
  • ,
  • Jared P. Walsh

      Affiliations

    • Massachusetts General Hospital Schizophrenia Program, Freedom Trail Clinic, 25 Staniford St., 2nd Floor, Boston, MA 02114, United States
  • ,
  • Melissa A. Culhane

      Affiliations

    • Massachusetts General Hospital Schizophrenia Program, Freedom Trail Clinic, 25 Staniford St., 2nd Floor, Boston, MA 02114, United States
    • Harvard Medical School, Boston, MA, United States
  • ,
  • Donald C. Goff

      Affiliations

    • Massachusetts General Hospital Schizophrenia Program, Freedom Trail Clinic, 25 Staniford St., 2nd Floor, Boston, MA 02114, United States
    • Harvard Medical School, Boston, MA, United States

Received 6 October 2006; received in revised form 14 December 2006; accepted 20 December 2006. published online 26 February 2007.

Abstract 

Rationale

Risperidone augmentation of clozapine in refractory schizophrenia has theoretical but only inconsistent support from clinical trials.

Objectives

To examine if adding risperidone to stable yet symptomatic schizophrenia outpatients on optimized clozapine monotherapy improves psychopathology.

Methods

We conducted a double-blind placebo-controlled parallel-group trial of a fixed dose of 4 mg/day risperidone added for 6 weeks in 24 outpatients with schizophrenia.

Results

Subjects who received risperidone showed a non-significant decrease in PANSS total score. The PANSS disorganized thought subscale improved significantly (β=3.3079, p=0.047).

Conclusions

Our trial does not support the routine addition of risperidone to clozapine in refractory schizophrenia patients. However, much larger trials are needed to conclusively settle the question of added efficacy from this combination.

Keywords: Schizophrenia, Clozapine, Risperidone, Polypharmacy

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 Funding for this trial was provided by a grant from the Stanley Medical Research Institute (Oliver Freudenreich).

PII: S0920-9964(07)00032-1

doi:10.1016/j.schres.2006.12.030

Schizophrenia Research
Volume 92, Issue 1 , Pages 90-94, May 2007