Adjunctive Depot Antipsychotic in Treatment-Resistant Schizophrenia

Abstract

Objectives: Since according to some studies, atypical antipsychotics were connected with better results and lesser adverse effects in comparison with conventional ones, at the present time the later kind of medications are the preferred category of antipsychotics in clinical management of schizophrenia. But such a maneuver has not decreased hitherto the dilemma of treatment —resistance. The objective of the present assessment included evaluation of the effectiveness of adjunctive flupentixol decanoate in schizophrenic patient, who had responded inadequately to aripiprazole. Method: 24 male inpatients with diagnosis of schizophrenia, who had displayed poor response to aripiprazole, were entered into an eight-week, single-blind evaluation for random assignment to current antipsychotic treatment (aripiprazole) or aripiprazole plus adjunctive flupentixol decanoate. While the Scale for Assessment of Negative Symptoms (SANS) and the Scale for Assessment of Positive Symptoms (SAPS) were used as the primary outcome measures, the Clinical Global Impressions-Severity Scale (CGI-S), the Schedule for Assessment of Insight (SAI), and finally the Simpson-Angus Scale (SAS) were used as ancillary measures. Results: According to the results, while the mean total scores of CGI-S, SAI and SAPS in the augmented group dropped significantly in comparison with the aripiprazole group (p<0.007, p<0.03, p<0.001, respectively), with around 19.55% decrement of SAPS in the augmented group, the reduction in the mean total score of SANS was not significant in between -group analysis (P<0. 07). In addition, the mean total score of SAS was meaningfully improved in the target group (P< 0. 0000). The effect size (ES) analysis also revealed a great improvement with flupentixol augmentation regarding SAPS, SAI and CGI-S. Conclusion: While occurrence of extra-pyramidal adverse effects should not be overlooked by clinicians, addition of flupentixol decanoate to aripiprazole can be helpful for a number of poorly responsive schizophrenic patients. Keywords: Aripiprazole, extra-pyramidal, flupenthixol decanoate, poor response, treatment resistant, schizophrenia.