Emerging treatments
Augmentation therapies for clozapine resistance
Over 50% of patients treated with clozapine do not respond to this medication alone. There is some evidence that in those patients augmentation with amisulpride plus aripiprazole, or with mirtazapine, or with ethyl eicosapentaenoic acid is beneficial.[74]
Novel adjunctive therapies
The efficacy of novel, adjunctive pharmacotherapies for treatment of cognitive deficits in schizophrenia or schizoaffective disorder is undergoing investigation. Meta-analysis has found that cholinergic and glutamatergic agents can improve negative and general symptoms, whereas serotonergic medications can improve positive symptoms.[75] One Cochrane review found that the addition of a selective norepinephrine-reuptake inhibitor, such as reboxetine (not available in the US), may help improve negative symptoms (very low-quality evidence).[76]
Transcranial magnetic stimulation
Although some evidence exists showing improvement in certain symptoms of schizophrenia (auditory hallucinations and positive symptoms) with transcranial magnetic stimulation (TMS), results have been mixed and not robust enough to suggest any added benefit.[32][77][78] Additionally, there is a lack of studies specifically looking into TMS treatment in individuals with schizoaffective disorder.
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