Amisulpride in Addition to Clozapine: A Retrospective Study Indicates Improved Efficacy and Good Tolerability

Background: The common practice of augmenting the efficacy of clozapine by addition of amisulpride has some empirical and theoretical support, but has not been thoroughly investigated. Objective: We report on 14 patients (8 inpatients, 6 outpatients) with a mean age of 34.4 years (SD 8.6), who had received a combined clozapine/amisulpride treatment. 8 patients were suffering from schizophrenia (ICD-10 F20.0), 6 from a schizoaffective disorder (ICD-10 F20.5). All patients had received clozapine at a dosage of 338±177 mg for at least 4 weeks, amisulpride was added at a dosage of 514±235 mg, and combined treatment lasted for 20±22 weeks. Results: The mean CGI score (severity of illness item) decreased from 5.6±0.5 to 3.9±1.0 (p<.01). Accordingly, the CGI score (global improvement item) revealed that three patients (21%) were “very much improved”, eight patients (57%) “much improved”, two patients (14%) “minimally improved”, and only one patient (7%) was “not improved”. No patients experienced deterioration, and no severe side effects were reported. Conclusions: It is concluded that a combination of clozapine and amisulpride might be useful for patients not improving sufficiently under clozapine monotherapy (German J Psychiatry 2003; 6(3): 64-68)