Clozapine After 1 Failed Antipsychotic Drug Trial in First-Episode Psychosis: A Randomized Clinical Trial - PubMed

2 days ago

Clozapine was studied as a treatment option for first-episode psychosis (FEP) patients who did not respond to one previous antipsychotic drug trial.
The trial was a sequential, assessor-blind study conducted across 7 centers in China from 2019 to 2022, involving patients aged 16-45 with FEP.
In phase 1, patients were randomized to receive olanzapine, risperidone, amisulpride, aripiprazole, or perphenazine for 8 weeks.
Phase 2 involved nonresponders from phase 1 being rerandomized to olanzapine, amisulpride, or clozapine for another 8 weeks.
Response rates in phase 1 were highest for risperidone (63.4%) and amisulpride (61.8%), and lowest for aripiprazole (44.3%) and perphenazine (45.7%).
In phase 2, clozapine showed superior efficacy with a 62.5% response rate compared to 31.7% for olanzapine and 44.7% for amisulpride.
The study suggests clozapine as a viable next treatment after failure of a traditional antipsychotic in FEP patients.

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