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References

230 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 1 References

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  19. Hsu WY, et al. Aripiprazole in treatment-­refractory schizophrenia. J Psychiatr Pract 2009; 15:221–226. Treatment Examples Comments Strength of evidence Physical treatments ECT, rTMS, tDCS, DBS Best evidence for ECT as adjunct to clozapine. Others still largely experimental. Modest ++ Adjunctive antidepressants Mirtazapine, vortioxetine, SSRIs Limited data available suggest small benefits in negative and cognitive symptoms. Weak + Adjunctive anticonvulsants Lamotrigine, topiramate, sodium valproate, carbamazepine Data difficult to interpret Weak + Psychological therapies CBT Conflicting findings, effects small. Very weak ± CBT, cognitive behavioural therapy; DBS, deep brain stimulation; NSAIDs, non-­steroidal anti-­inflammatory drugs; rTMS, repetitive transcranial magnetic stimulation; tDCS, transcranial direct current stimulation. Table 1.54  (Continued)

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