STM Article Repository

Aims: About 40% to 70% of patients with treatment-resistant schizophrenia respond inadequately to clozapine. Augmentation with other medications or electroconvulsive therapy confers very little benefit in clozapine non-response. Research on augmentation with psychosocial treatments in clozapine-resistance is limited, but shows some promise. The benefits of psychosocial interventions in augmenting clozapine-response are highlighted by the treatment histories of three patients with treatment-resistant schizophrenia who responded poorly to clozapine.

Presentation of Cases: In these three patients with clozapine-resistance, combining cognitive-behavioral therapy (CBT) with family-psychoeducation, individual supportive treatment and stress-management yielded more enduring and a greater range of benefits, than could be achieved with augmentation by somatic treatments.

Discussion: The success achieved with these patients advocates the need for more randomized-controlled trials to examine the efficacy of psychosocial interventions in augmenting inadequate treatment-response among patients with clozapine-resistance.

Conclusion: Psychosocial interventions, which combine CBT with other treatment-modalities such as individual support, family-psychoeducation and stress-management, might be more useful in augmenting clozapine non-response.