SynthesisSchizophrenia bulletin2009
Antipsychotic combinations vs monotherapy in schizophrenia: a meta-analysis of randomized controlled trials.
Synthesis in Schizophrenia bulletin, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04395326 (Monitoring of Metabolic Adverse Events of Second Generation Antipsychotics in a Naive Pediatric Population Followed in Mental Health Outpatient and Inpatient Clinical Settings), which is not on this map. Cited by 125 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Monitoring of Metabolic Adverse Events of Second Generation Antipsychotics in a Naive Pediatric Population Followed in Mental Health Outpatient and Inpatient Clinical Settings (MEMAS Prospective Study)
Who cites it
125 citing papers in PubMed, 8 syntheses or guidelines pooled it, 393 citations in OpenAlex.
- Adjunctive bilateral vs. unilateral or sham repetitive transcranial magnetic stimulation for major depressive disorder or bipolar depression: a meta-analysis of randomized controlled studies.European journal of medical research · 2025Pooled it
- Antipsychotic combinations for schizophrenia.The Cochrane database of systematic reviews · 2017Pooled it
- Pooled it
- Antipsychotic Polypharmacy and Corrected QT Interval: A Systematic Review.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2015Pooled it
- Adjunctive use of nonsteroidal anti-inflammatory drugs for schizophrenia: a meta-analytic investigation of randomized controlled trials.Schizophrenia bulletin · 2013Pooled it
- Adjunctive aripiprazole versus placebo for antipsychotic-induced hyperprolactinemia: meta-analysis of randomized controlled trials.PloS one · 2013Pooled it
- Prevalence and correlates of antipsychotic polypharmacy: a systematic review and meta-regression of global and regional trends from the 1970s to 2009.Schizophrenia research · 2012Pooled it
- Clozapine combined with different antipsychotic drugs for treatment resistant schizophrenia.The Cochrane database of systematic reviews · 2009Pooled it
- Combination Antipsychotic Therapies: An Analysis From a Longitudinal Pragmatic Trial.Journal of clinical psychopharmacology · 2017Trial
- Evaluation of the individual safe correction of antipsychotic agent polypharmacy in Japanese patients with chronic schizophrenia: validation of safe corrections for antipsychotic polypharmacy and the high-dose method.The international journal of neuropsychopharmacology · 2014Trial
- Validation of a claims-based antipsychotic polypharmacy measure.Pharmacoepidemiology and drug safety · 2014Trial
- Effectiveness of switching from antipsychotic polypharmacy to monotherapy.The American journal of psychiatry · 2011Trial
- Adjunctive risperidone for partially responsive people with schizophrenia treated with clozapine.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2010Trial
- Trial
- Analysis of drug-drug interactions between psychiatric drugs in spontaneous adverse drug reaction reports from EudraVigilance.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Combining Three Long-acting Injectable Antipsychotics: A Case Series.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2026Article
- Impact of treatment with long‑acting injectable antipsychotics on hospitalization and relapse rates in schizophrenia spectrum disorders: a 3‑year follow-up mirror‑image study.Therapeutic advances in psychopharmacology · 2026Article
- Prevalence and associated factors of metabolic syndrome among Omani adults with mental illnesses: a cross-sectional study.Scientific reports · 2025Article
- Polypharmacy in psychiatry and weight gain: longitudinal study of 832 patients hospitalized for depression or schizophrenia, along with data of 3180 students from Europe, the U.S., South America, and China.European archives of psychiatry and clinical neuroscience · 2025Article
- Evaluation of Prescription Patterns of Antipsychotics in Schizophrenia Patients-A Single-Center Prospective Study.Journal of clinical medicine · 2025Article
65 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
contextDespite lacking evidence for its safety and efficacy, antipsychotic cotreatment is common in schizophrenia.
objectiveTo evaluate therapeutic and adverse effects of antipsychotic cotreatment vs monotherapy in schizophrenia. DATA SOURCES: Cochrane Schizophrenia Group register and hand searches of relevant journals/conference proceedings. STUDY SELECTION: Randomized controlled trials comparing antipsychotic monotherapy to cotreatment with a second antipsychotic. DATA EXTRACTION AND ANALYSIS: Two authors independently extracted data. For homogenous dichotomous data, we calculated random effects, relative risk (RR), 95% confidence intervals (CIs), and numbers needed to treat (NNT). For continuous data, weighted mean differences were calculated.
resultsIn 19 studies (1229 patients) with 28 monotherapy and 19 cotreatment arms, antipsychotic cotreatment was superior to monotherapy regarding 2 a priori defined coprimary outcomes: less study-specific defined inefficacy (N = 22, n = 1202, RR = 0.76, CI = 0.63-0.90, P = .002, NNT = 7, CI = 4-17, P = .0008, I(2) = 78.9%) and all-cause discontinuation (N = 20, n = 1052, RR = 0.65, CI = 0.54-0.78, P < .00001). Results were consistent using Clinical Global Impressions thresholds of less than much (P = .006) and less than minimally (P = .01) improved. Specific psychopathology and adverse event data were insufficient to yield meaningful results. In sensitivity analyses, 5 efficacy moderators emerged: concurrent polypharmacy initiation, clozapine combinations, trial duration >10 weeks, Chinese trials, and second-generation + first-generation antipsychotics. In a meta-regression, similar dose combinations, second-generation + first-generation antipsychotics and concurrent polypharmacy initiation remained significant.
conclusionsIn certain clinical situations, antipsychotic cotreatment may be superior to monotherapy. However, the database is subject to possible publication bias and too heterogeneous to derive firm clinical recommendations, underscoring the need for future research.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.