Schizophrenia

Canadian Journal of Psychiatry

• Canadian guidelines for management of schizophrenia

Augmentation Strategies 

• Evidence on clozapine combination and augmentation strategies

1. Which pathway is responsible for positive symptoms? 

a) Mesolimbic

b) Mesocorticol

c) Nigrostriatal

d) Tuberoinfundibular

2. The following are negative symptoms EXCEPT

a) Poverty of speech

b) Lack of motivation

c) Disorganized speech

d) Attention deficit

3. A patient has been on risperidone 1 mg daily for two weeks (first antipsychotic trial). They have noticed an improvement from baseline functioning by approximately 50%. What is recommended for this patient?

a) Continue risperidone 1 mg once daily

b) Increase risperidone to 2mg once daily (titrate up to optimal dose as tolerated)

c) Switch to olanzapine

d) Switch to clozapine

4. Patient is currently on loxapine 20 mg daily and is experiencing involuntary movement of lower mouth (tardive dyskinesia). The following are appropriate management strategies EXCEPT:

a) Reduce loxapine to 15 mg once daily 

b) Switch to quetiapine

c) Start pyridoxine

d) Add benztropine

5. Your patient is currently on clozapine once daily and has noticed excessive salivation. What would you recommend for management?

a) Augment with aripiprazole

b) Start propranolol

c) Give clozapine BID (divide daily dose)

d) Start lorazepam