Clozapine is still the drug of choice for patients with schizophrenia. However, there are still many patients not having a satisfied response to clozapine. In these patients clozapine is very often combined with other antipsychotics but the evidence for these combinations is poor. Due to the receptor profile of clozapine, the augmentation drug should be a non-sedating drug with no muscarinergic affinity and still have a low propensity to cause EPS. Sertindole has not been investigated as an augmentation drug to clozapine.

We present a 29 year old man with a treatment resistant schizophrenia. Currently he was treated with 400 mg of clozapine with a suboptimal response but was not able to tolerate a higher clozapine dose due to sedation. Sertindole 16 mg was instead added.

The baseline PANSS total score was 123 and after 12 weeks it was reduced to 90. No subjective or objective side-effects were seen.

Sertindole might be an ideal augmentation drug to clozapine due to the receptor profile but whether the combination is beneficial needs to be determined in a randomized double-blinded placebo trial.