Comparison Of Effect Of Addition Of Fluvoxamine Or Risperidone To Clozapine In Chronic Partially Responsive Schizophrenic Patients On Clinical Response, QTc interval And Lipid profile

Abstract

Objective To study and compare the augmentation effect of addition of fluvoxamine or risperidone in chronic partially responsive schizophrenic patients receiving clozapine on clinical and laboratory parameters. Methods - A prospective, randomized, parallel, open label 12 weeks study. The schizophrenic patients, aged 20-60 years, who followed the DSM-IV diagnostic criteria and receiving clozapine therapy, showing partial response to the treatment were recruited and the study was carried out from January 2007 to June 2008. Subjects were randomized into two groups: Group A (n=28): fluvoxamine (25-50mg/day) was added to clozapine (25-200mg/day) and Group B (n=27): risperidone (1-5mg/day) was added to clozapine therapy. The effect of drugs was assessed by PANSS, BPRS scale and ECG and lipid profile were done at 6 and 12 weeks. Result - There was significant decrease in PANSS and BPRS score in both groups. Fluvoxamine + clozapine significantly reduced PANSS score as compared to risperidone + clozapine compared to baseline and between 6 and 12 weeks. Risperidone +clozapine prolonged QTc interval (at 12 weeks) and elevated serum TG, VLDL, HDL significantly at 6 and 12 weeks. Conclusion Although addition of fluvoxamine and risperidone to clozapine are effective in management of chronic partially responsive schizophrenia on clozapine, fluvoxamine is more effective as well as safer compared to Risperidone when compared for 6 and 12 weeks in these patients.