Sun. Oct 13, 2019 1:00 PM - 2:40 PM Room 5 (410)

Organizer / Chair: Hidehiro OSHIBUCHI (Department of Psychiatry, Tokyo Women's Medical University, Japan), Co-chair: Takefumi SUZUKI (Department of Neuropsychiatry, University of Yamanashi, Japan), Discussant: ‌Yasuhiro KANEDA (Department of Psychiatry, Iiwaki Clinic, Japan)

Clozapine is considered the gold standard treatment for patients with treatment-refractory schizophrenia (TRS), but a recent network meta-analysis raises questions about its relative superiority over other second-generation antipsychotics such as olanzapine and risperidone. In this symposium, we will discuss evidence for the superior efficacy of clozapine treatment not only for psychotic symptoms, but also for the negative symptoms and emotional symptoms of TRS, including our recent clinical findings of clozapine’s efficacy for “treatment adherence”, “re-hospitalization”, and “seclusion”, and the utility of plasma clozapine levels for assessing its efficacy. In addition, we will present basic research findings regarding the effects of clozapine on the amygdala dopamine system in fear-conditioned animals. The data suggest specific actions of clozapine on emotional cognitive-processing comparing with other antipsychotics. These presentations suggest future standards for more efficient clozapine treatment strategies for patients with TRS.