P03-88 - Amisuplpride-quetiapine-memantine association as treatment for resistant schizophrenia. Case report

Abstract

Objectives

There are no obvious data to sustain that amisulpride-quetiapine-memantine association would induce remision of resistant schizophrenia. The clinical consequences and the challenge of medication for resistant schizophrenia are important. This case report brings additional information about therapy in resistant schizophrenia.

Methods

Case Report: 38 years old patient, male, with repeated hospitalizations for schizophreniaparanoid type, from 1989; the precedent psychotic episodes were treated with haloperidol, risperiodone,amisulpride, olanzapine, clozapine and quetiapine. The latest episode was treated with olanzapine (20mg/day- 8 weeks), with failure, and, after that, with clozapine (500mg/day- 8 weeks) without remission. The patient has been hospitalized after olanzapine and clozapine treatment failure and treated with association of two different classes of neuroleptics (amisulpride 800mg/day and quetiapine 200mg/day) and memantine (10mg/day).

Results

The treatment with amisulpride-quetiapine- memantine association induced remission of symptoms and discharge from hospital after 18 days of treatment, sustained by PANSS score reduction (from105 at hospitalization to 40 at discharge). This symptoms remission is important because it happens after clozapine treatment failure, with known efficacy for treatment resistant schizophrenia.

Conclusions

For a patient with schizophrenia-paranoid type, treatment resistant, amisulpride-quetiapine- memantine association had the power to induce remission of symptoms. The combinated multireceptoral D2, 5HT2A, NMDA action of medication may be important in choosing the treatment for resistant schizophrenia.