[Risperidone as adjunctive therapy in clozapine treatment of refractory schizophrenia: a meta-analysis of randomized, placebo-controlled trials]

OBJECTIVE: To establish whether augmentation of ongoing clozapine treatment with risperidone is efficacious in patients unresponsive or partially responsive to clozapine alone. METHOD: A meta-analysis of randomized, placebo-controlled clinical trials. RESULTS: In the presented meta-analysis of randomized, placebo-controlled trials risperidone augmentation of ongoing clozapine treatment in patients with refractory schizophrenia was not not found to be an effective method as assessed either by the odds ratio of patients showing an at least 20% improvement on clinical scales, or by the effect size calculated from continuous measures of psychopathology. The treatment outcome seems to be independent of the trial duration. Further independent clinical trials are needed to confirm the suggestion that the best response can possibly be obtained using moderate (44.5 mg/day) doses of risperidone. CONCLUSIONS: Risperidone augmentation of clozapine in the treatment of patients unresponsive or partially responsive to clozapine alone cannot be recommended as a standard clinical procedure.