S114. EFFICACY OF THE SEROTONIN 5HT-2A INVERSE AGONIST PIMAVANSERIN IN REFRACTORY HALLUCINATIONS AND DELUSIONS THAT FAILED TO RESPOND TO CLOZAPINE OR OTHER ANTIPSYCHOTICS

摘要

Clozapine was the first and the widely accepted gold standard treatment for refractory or treatment-resistant psychotic symptoms (hallucinations and delusions) which can occur in up to 30% of patients with schizophrenia. Clozapine has efficacy in about 50% of treatment-refractory cases and some responding patients have to discontinue it due to serious adverse effects like agranulocytosis, diabetes, myocarditis or ileus. The search for novel agents to use for clozapine-non-responders continues. One such possible agent is the non-dopaminergic antipsychotic pimavanserin, an inverse agonist of serotonin 5-HT2A receptors which was recently approved for the hallucinations and delusions of Parkinson’s Disease Psychosis. We report here the successful results of using pimavanserin in patients with refractory hallucinations and delusions who failed to respond to clozapine. We also report similar results in refractory psychosis patients who did not receive clozapine