Amisulpride Augmentation in Schizophrenia Patients with Poor Response to Olanzapine: A 4-week, Randomized, Rater-Blind, Controlled, Pilot Study

Introduction Olanzapine (OLA) is a common first-prescribed antipsychotic and has shown favorable efficacy in acutely exacerbated patients with schizophrenia. The mixed receptor activity of OLA its greater affinity for serotonin 5-HT2A rather than dopamine D2 receptors are similar to those clozapine. Pharmacokinetically, metabolized mainly by hepatic cytochrome enzyme P450 1A2 (CYP1A2). Because risks polypharmacy include increased drug-drug interactions, pharmacokinetic considerations important selection antipsychotics be combined. Due pharmacological characteristics, amisulpride (AMI), another atypical proven efficacy, promising adjuvant agent special interest. AMI unlikely interact other drugs due the low plasma protein binding metabolism does not affect CYP system. Furthermore, highly selective D2/D3 receptors; minimal or no D1, D4, D5 receptors. Despite potential benefits combination AMI, only few open-label studies have been conducted, randomized clinical trial performed date examine tolerability combination. Hence, goals this study were test hypothesis that augmentation would improve psychotic symptoms well tolerated schizophrenic who showed poor response monotherapy. Objectives purpose was compare continued olanzapine versus (AMI) Methods present 4-week, randomized, rater-blinded included 25 schizophrenia partially completely unresponsive treatment Eligible subjects randomly assigned at 1:1 ratio continuation monotherapy (OLA group) (AMI group). Efficacy primarily evaluated using Positive Negative Syndrome Scale (PANSS) baseline 1, 2, 4 weeks. Results changes PANSS total score PANSS-positive subscale significantly different (p < 0.05) between groups. differences two groups PANSS-negative subscale, PANSS-general Brief Psychiatric Rating Scale, Clinical Global Impression-Severity (CGI-S) scale scores statistically significant. Conclusions could an effective strategy show inadequate early Disclosure Interest W.-M. Bahk Grant / Research support from: Handok Pharmaceuticals, Seoul, Korea, Y. S. Woo: None Declared, S.-Y. Park: B.-H. Yoon: S.-M. Wang: M.-D. Kim: Declared