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Amisulpride Augmentation of Clozapine in Refractory Schizophrenia

Amisulpride Augmentation of Clozapine in Refractory Schizophrenia


Department of Psychiatry, Beitou Armed Forces Hospital, 60, Xinmin Rd., Beitou Dist., Taipei 112, Taiwan. e-mail address: siskoala{at} (Ms. Chiu), drhuangsd{at} (Dr. Huang) To the Editor: Clozapine, an atypical antipsychotic drug, is the first-choice medication for treatment-refractory schizophrenia. However, clozapine can cause some adverse effects, such as agranulocytosis and sialorrhea, making it difficult for patients to continue with treatment. Otherwise, treatment options for patients who are resistant to clozapine are extremely limited. Herein, the authors report the case of a patient with refractory schizophrenia treated by amisulpride augmentation of clozapine who got significant improvement not only in his positive and negative symptoms but also the side effect of salivation. This case report might provide an alternative treatment for refractory schizophrenia.Case Report A 53-year-old man with chronic, refractory schizophrenia was hospitalized because of his symptoms of hostility, aggression, insomnia, delusions, and auditory hallucinations, despite his medication with clozapine 200 mg per day. His initial laboratory studies revealed no remarkable findings. Clozapine was titrated to 350 mg per day for marked psychotic symptoms, but it seemed to be only slightly effective. Meanwhile, he complained of salivation worsening and wanted to discontinue clozapine treatment because of this adverse effect. We then
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