What can we do if clozapine fails? Pharmacologic choices and differential outcomes

Abstract

What to do when clozapine therapy (or other medications) does not work … or, more often, doesn’t work well enough? This is a real clinical conundrum. Moreover, clinicians struggle daily with the dilemma of distilling information on appropriate augmentation strategies from studies of groups of patients and thereupon extrapolating that information to the individual patient in their practice. This is a complicated equation at the time when the clinician and/or the patient conclude that clozapine therapy has reached its plateau and other options are called for. This chapter will detail the range of options as well as some considerations for selecting one choice over another for given patient scenarios.