Clozapine–treatment–resistant schizophrenia successfully managed with brexpiprazole combination therapy and online meta-cognitive training: A case report
Bibliographic record
Abstract
Clozapine is considered one of the best effective strategies in treatment-resistant schizophrenia (TRS), despite up to 60% of clozapine-treated patients not adequately and/or fully achieving a clinical response either partial remission (clozapine-resistant treatment, CRT). Hence, several combination strategies to clozapine have been investigated in CRT. Hereby, we describe a 50-year-old CRT male patient successfully managed with brexpiprazole augmentation strategy. The patient was assessed at the baseline, weekly up to week 4 and monthly after that up to week 16, with the following psychopathological rating scales: Clinical Global Impression - Improvement (CGI-I), Brief Psychiatric Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS) Calgary Depression Scale for Schizophrenia (CDSS), Montgomery-Asberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS), Hamilton Rating Scale for Anxiety (HRS-A), Barnes Akathisia Scale (BARS), and Abnormal Involuntary Movement Scale (AIMS). At 1-month follow-up, he already showed a considerable improvement at the psychopathological assessment (63% total PANSS reduction). At 4-month follow-up, a further 50% PANSS total reduction was observed from the baseline. After 1-year of clozapine-brexpiprazole treatment, the patient was also administered an online metacognitive training (MCT) as adjunctive intervention, by reporting a further clinical improvement.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".