Clin Psychopharmacol Neurosci.  2019 Nov;17(4):559-563. 10.9758/cpn.2019.17.4.559.

Efficacy of Asenapine in Schizophrenia Resistant to Clozapine Combined with Electroconvulsive Therapy: A Case Report

  • 1Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan.


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.


Asenapine; Treatment-refractory schizophrenia; Clozapine; Electroconvulsive therapy; Suicide; Recurrence
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