Lurasidone vs. Other Antipsychotics as Augmentation Strategies for Clozapine in Treatment-resistant Schizophrenia: An Observational Multicenter Prospective Study.

INTRODUCTION

Clozapine, after its introduction, reshaped the landscape of Treatment- Resistant Schizophrenia (TRS) treatment, becoming the first-line treatment for that condition. However, many patients fail to respond to this drug alone. Clozapine-resistant schizophrenia (CRS) is associated with a more severe clinical presentation than TRS, manifesting in exacerbated symptoms and significantly diminished quality of life. The complex nature of CRS has prompted the development of augmentation strategies, which most commonly include another antipsychotic. The present multicenter observational study aimed to assess and compare the efficacy of Lurasidone augmentation alongside clozapine versus other second-generation antipsychotic combinations in patients with a schizophrenia spectrum disorder.

METHODS

A total of 45 patients with a diagnosis of a schizophrenia spectrum disorder and labeled as "treatment resistant" were included. Functional and psychometric assessments were made at the baseline, one month, and six months after the treatment. A linear mixed-effect regression was performed along with other appropriate statistical analyses.

RESULTS

A significant improvement over time was observed in the two groups for both the clinical and functional outcomes assessed, demonstrating the efficacy of a proper augmentation strategy in CRS management. Moreover, significantly lower psychiatric ward admissions were observed in the lurasidone group (p<.05).

DISCUSSION: Our findings suggest that lurasidone augmentation in CRS offers significant improvements in psychopathological domains similar to alternative augmentation strategies.

CONCLUSION

Although further studies are needed to confirm our findings, lurasidone's favorable side-effect profile should be considered.