The effect of lamotrigine augmentation of clozapine in a sample of treatment-resistant schizophrenic patients: A double-blind, placebo-controlled study

Zoccali, R.; Muscatello, M.R.; Bruno, A.; Cambria, R.; Micò, U.; Spina, E.; Meduri, M.

doi:10.1016/j.schres.2007.02.009

« Previous Next »Schizophrenia Research
Volume 93, Issue 1 , Pages 109-116, July 2007

The effect of lamotrigine augmentation of clozapine in a sample of treatment-resistant schizophrenic patients: A double-blind, placebo-controlled study

R. Zoccali
- Section of Psychiatry, Department of Neurosciences, Psychiatric and Anaesthesiological Sciences, University of Messina, Italy
- Corresponding author. Department of Neurosciences, Psychiatric and Anesthesiological Sciences, Policlinico Universitario Via Consolare Valeria-Messina 98125 Italy. Tel.: +39 090 22212092; fax: +39 090 695136.
M.R. Muscatello
- Section of Psychiatry, Department of Neurosciences, Psychiatric and Anaesthesiological Sciences, University of Messina, Italy
A. Bruno
- Section of Psychiatry, Department of Neurosciences, Psychiatric and Anaesthesiological Sciences, University of Messina, Italy
R. Cambria
- Section of Psychiatry, Department of Neurosciences, Psychiatric and Anaesthesiological Sciences, University of Messina, Italy
U. Micò
- Section of Psychiatry, Department of Neurosciences, Psychiatric and Anaesthesiological Sciences, University of Messina, Italy
E. Spina
- Section of Pharmacology, Department of Clinical and Experimental Medicine and Pharmacology, University of Messina and IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
M. Meduri
- Section of Psychiatry, Department of Neurosciences, Psychiatric and Anaesthesiological Sciences, University of Messina, Italy

Received 6 November 2006; received in revised form 12 February 2007; accepted 16 February 2007. published online 31 March 2007.

Abstract

Based on the evidence that lamotrigine added to clozapine in refractory schizophrenic patients has reported promising results, the present 24-week double-blind, randomized, placebo-controlled trial had the aim to explore the efficacy of lamotrigine add-on pharmacotherapy on clinical symptomatology and cognitive functioning in a sample of treatment-resistant schizophrenic patients receiving clozapine. After clinical and neurocognitive assessments patients were randomly allocated to receive, in a double-blind design, either up to 200 mg/day of lamotrigine or a placebo. A final sample of fifty-one patients completed the study.

The results obtained indicate that lamotrigine added to stable clozapine treatment showed a beneficial effect on the negative, positive and general psychopathological symptomatology in a sample of treatment-resistant schizophrenic patients. Regarding cognitive functions, improvement was observed in some explored areas, such as attentional resistance to interference, verbal fluency and executive functioning. The findings provide evidence that lamotrigine augmentation of clozapine treatment is well tolerated and may be proposed as an effective therapeutic strategy to improve outcome in treatment-resistant schizophrenia.

Keywords: Lamotrigine, Schizophrenia, Augmentation, Clozapine, Treatment, Resistant