Brief ReportsAugmentation of Clozapine With Agomelatine in Partial-Responder Schizophrenia A 16-Week, Open-Label, Uncontrolled Pilot StudyBruno, Antonio MD, PhD*; Zoccali, Rocco A. MD*; Abenavoli, Elisabetta MD, PhD*; Pandolfo, Gianluca MD, PhD*; Scimeca, Giuseppe PsyD, PhD*; Spina, Edoardo MD†; Muscatello, Maria Rosaria Anna MD, PhD* Author Information From the Departments of *Neurosciences, and †Clinical and Experimental Medicine and Pharmacology, University of Messina, Messina, Italy. Received November 8, 2013; accepted after revision March 4, 2014. Reprints: Antonio Bruno, MD, PhD, Department of Neurosciences, Policlinico Universitario Via Consolare Valeria, Messina 98125, Italy (e-mail: [email protected]). Journal of Clinical Psychopharmacology: August 2014 - Volume 34 - Issue 4 - p 491-494 doi: 10.1097/JCP.0000000000000157 Buy Metrics Abstract The present 16-week open-label uncontrolled trial was aimed to explore the efficacy of adjunctive agomelatine on clinical symptoms and cognitive functioning in 20 schizophrenia patients showing partial response (Brief Psychiatric Rating Scale, mean [SD] baseline total score = 37.5 [6.6]) to clozapine monotherapy at the highest tolerated dosage. The results obtained evidenced that agomelatine at a dosage of 50 mg/d was associated with score reduction in all Positive and Negative Syndrome Scale domains (positive, P = 0.011 and Cohen d = 0.7; negative, P < 0.0001 and Cohen d = 1.1; psychopathology, P = 0.001 and Cohen d = 0.9) and total score (P = 0.001, Cohen d = 1.2), depressive (Calgary Depression Scale for Schizophrenia, P = 0.013 and Cohen d = 0.6), and overall clinical symptoms (Brief Psychiatric Rating Scale, P = 0.001 and Cohen d = 0.6 ); moreover, improved performances on Stroop task (P = 0.006, Cohen d = 0.7) and Wisconsin Card Sorting Test “perseverative errors” (P = 0.033, Cohen d = 0.3) were observed. The favorable effect of agomelatine on clinical and cognitive symptoms was encouraging, and more research is needed to better identify subgroups of patients who are partially responsive to clozapine monotherapy in which agomelatine augmentation may be of benefit. © 2014 by Lippincott Williams & Wilkins.