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Clozapine-Treatment-Resistant Schizophrenia Successfully Managed with Brexpiprazole Combination Therapy: Two Case Reports

Published online by Cambridge University Press:  01 September 2022

L. Orsolini ,
S. Tempia Valenta ,
S. Bellagamba ,
V. Salvi  and
U. Volpe
L. Orsolini
Affiliation:
Unit of Clinical Psychiatry, Polytechnic University of Marche, Department Of Neurosciences/dimsc, Ancona, Italy
S. Tempia Valenta*
Affiliation:
Unit of Clinical Psychiatry, Polytechnic University of Marche, Department Of Neurosciences/dimsc, Ancona, Italy
S. Bellagamba
Affiliation:
Unit of Clinical Psychiatry, Polytechnic University of Marche, Department Of Neurosciences/dimsc, Ancona, Italy
V. Salvi
Affiliation:
Unit of Clinical Psychiatry, Polytechnic University of Marche, Department Of Neurosciences/dimsc, Ancona, Italy
U. Volpe
Affiliation:
Unit of Clinical Psychiatry, Polytechnic University of Marche, Department Of Neurosciences/dimsc, Ancona, Italy
*
*Corresponding author.

Abstract

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Introduction

Clozapine has proven to have a unique efficacy on treatment-resistant schizophrenia (TRS). Nevertheless, studies show that 47%-63% of clozapine-treated patients may fail to respond after around 12-years of treatment (CRS). Several augmentation strategies have been proven to be effective in CRS.

Objectives

Hereby, we present two clinical cases of CRS successfully managed with brexpiprazole augmentation.

Methods

A 48-year-old man without comorbid substance use, treated with clozapine-brexpiprazole augmentation, and a 20-year-old man with comorbid substance use, treated with clozapine-brexpiprazole combination and subsequently with twice-injection aripiprazole (TIA). They were administered with the following assessments at t0, t1-3 (first month), t4-8 (monthly until 6-month follow-up): CGI, BPRS, PANSS, CDSS, Craving VAS, BARS, BIS-11, HRS-A, MADRS, YMRS, AIMS.

Results

At 1-month follow-up, both patients showed a considerable improvement (respectively 75% and 55.9% reduction of PANSS total score). At 6-month follow-up, reached only with the first patient, we noticed a further improvement (an overall 37.5% reduction of PANSS total score from the baseline).

Conclusions

The present work is the first report describing combination treatment strategies with clozapine and brexpiprazole which appear to give promising results.

Disclosure

No significant relationships.

Keywords

schizophréniaBrexpiprazoleClozapine-Treatment-ResistantCombination Therapy
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S355 - S356
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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