Efficacy of asenapine in schizophrenia resistant to clozapine combined with electroconvulsive therapy: A case report
Shinichiro Ochi 1*, Saori Inoue 1, Yuta Yoshino 1, Hideaki Shimizu 1, Jun-ichi Iga 1, Shu-ichi Ueno 1
Department of Neuropsychiatry, Ehime University Graduate School of Medicine
Received: August 1, 2018; Revised: November 18, 2018; Accepted: November 19, 2018; Published online: November 19, 2018.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Schizophrenic patients resistant to antipsychotics are diagnosed as having treatment-refractory schizophrenia, and they are treated with clozapine. However, clozapine is sometimes combined with electroconvulsive therapy (ECT) if clozapine monotherapy fails. In this report, a severe treatment-refractory schizophrenic patient who did not respond to clozapine even with ECT, but who recovered with asenapine monotherapy, is presented. Asenapine, considered a serotonin spectrum dopamine modulator, is a new atypical antipsychotic with unique pharmacological features that is used not only for schizophrenia, but also for bipolar disorder. The unique features of asenapine may be effective for some treatment-refractory schizophrenic patients.
Keywords: asenapine, treatment-refractory schizophrenia, clozapine, electroconvulsive therapy, suicide, relapse