Effective Switch From Clozapine to Aripiprazole in Treatment-Resistant Schizophrenia and Comorbid Alcohol Use Disorder

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To the Editors
Although clozapine is standard pharmacotherapy in patients with treatment-resistant schizophrenia, 33% to 71% are nonresponders to clozapine.1 Clozapine-resistant schizophrenia is defined as having Brief Psychotic Rating scale improvement of less than 20% despite a trial of 8 weeks or more and plasma levels greater than 350 μg/L, no period of good social/occupational functioning for 5 years or more, Global Assessment Functioning of less than or equal to 40, Brief Psychotic Rating Scale total score of greater than or equal to 45, Clinical Global Impressions score of greater than or equal to 4, and a score of greater than or equal to 4 on 2 of 4 positive symptom items.2 We describe the first case report highlighting the effective switch from clozapine to aripiprazole, resulting in remission of co-occurring schizophrenia and severe alcohol use disorder.
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