Remission of schizophrenia seen with amisulpride, clozapine

(HealthDay)—Remission can be achieved for most cases of schizophrenia and schizophreniform disorder with amisulpride and clozapine, according to a study published online Aug. 13 in the The Lancet Psychiatry.

René S. Kahn, M.D., from Brain Center Rudolf Magnus in Utrecht, Netherlands, and colleagues recruited 481 participants from 27 centers in 14 European countries and Israel. Patients aged 18 to 40 years with schizophrenia, schizophreniform disorder, or schizoaffective disorder were treated for four weeks with amisulpride in an open-label design (phase 1); those who did not meet criteria for symptomatic remission were randomized to continue amisulpride or switch to olanzapine during a six-week double-blind phase (phase 2). In phase 3, patients who were not in remission at 10 weeks were given clozapine for an additional 12 weeks in an open-label design.

The researchers found that 371 patients completed open-label amisulpride treatment; after phase 1, 250 (56 percent) achieved remission. Ninety-three patients not in remission continued to the six-week double-blind trial; 77 percent completed the trial. Overall, 45 and 44 percent on amisulpride and olanzapine, respectively, achieved remission (P = 0.87). Twenty-eight of the 40 patients not in remission started clozapine; 28 percent of the 18 patients who completed treatment achieved remission.

“For most patients in the early stages of schizophrenia, symptomatic remission can be achieved using a simple treatment algorithm comprising the sequential administration of amisulpride and clozapine,” the authors write.

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