SynthesisSchizophrenia research2012
Prevalence and correlates of antipsychotic polypharmacy: a systematic review and meta-regression of global and regional trends from the 1970s to 2009.
Synthesis in Schizophrenia research, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 151 papers, 8 of them syntheses that pooled it.
What it found
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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.
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Who cites it
151 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Prevalence and risk factors for misuse of prescription psychotropic drug in patients with severe mental illness: A systematic review.Actas espanolas de psiquiatria · 2023Pooled it
- Antipsychotic dose reduction compared to dose continuation for people with schizophrenia.The Cochrane database of systematic reviews · 2022Pooled it
- Antipsychotic polypharmacy reduction versus polypharmacy continuation for people with schizophrenia.The Cochrane database of systematic reviews · 2022Pooled it
- Antipsychotic Polypharmacy Among Patients With Schizophrenia in Africa: A Systematic Review and Meta-Analysis.The international journal of neuropsychopharmacology · 2021Pooled it
- Anticholinergic Burden and Cognitive Performance in Patients With Schizophrenia: A Systematic Literature Review.Frontiers in psychiatry · 2021Pooled it
- Schizophrenia.Deutsches Arzteblatt international · 2020Pooled it
- Antipsychotic combinations for schizophrenia.The Cochrane database of systematic reviews · 2017Pooled it
- Antipsychotic Polypharmacy and Corrected QT Interval: A Systematic Review.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2015Pooled it
- Combination Antipsychotic Therapies: An Analysis From a Longitudinal Pragmatic Trial.Journal of clinical psychopharmacology · 2017Trial
- Housing First Improves Adherence to Antipsychotic Medication Among Formerly Homeless Adults With Schizophrenia: Results of a Randomized Controlled Trial.Schizophrenia bulletin · 2017Trial
- Validation of a claims-based antipsychotic polypharmacy measure.Pharmacoepidemiology and drug safety · 2014Trial
- Study protocol: safety correction of high dose antipsychotic polypharmacy in Japan.BMC psychiatry · 2014Trial
- Beyond Clozapine Failure: Precision Approach and Palliative Psychiatry in Ultra-Treatment-Resistant Schizophrenia.Journal of clinical medicine · 2026Review
- A Claims Data-Based Comparison of Treatment Continuation between Aripiprazole Once-monthly and Paliperidone Palmitate in Routine Practice.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2026Article
- Real-world antipsychotic prescribing patterns and mortality in schizophrenia: a registry cohort study from China.Epidemiology and psychiatric sciences · 2026Article
- Real-world antipsychotic prescribing patterns in psychotic disorders: polypharmacy, clozapine, and long-acting injectable use in a tertiary outpatient cohort.Irish journal of medical science · 2026Article
- Adverse effect MonoPoly: Antipsychotic monopharmacy vs antipsychotic polypharmacy in the treatment of schizophrenia.Indian journal of psychiatry · 2026Article
- Disease-specific therapeutic plasma concentration ranges for quetiapine in schizophrenia, manic episode, depressive episode, and depressive comorbid insomnia.Discover mental health · 2026Article
- Insomnia Severity in Psychiatric Outpatients: Real-World Insomnia Severity Index Data from an Italian Community Mental Health Center.Brain sciences · 2026Article
- Association Between Psychiatrists' Subjective Clinical Behavior Scores and Objective Quality Indicators Based on Discharge Prescriptions: A Nationwide Multicenter Study Based on the EGUIDE Project.Neuropsychopharmacology reports · 2026Observational
91 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectiveTo assess the prevalence and correlates of antipsychotic polypharmacy (APP) across decades and regions.
methodsElectronic PubMed/Google Scholar search for studies reporting on APP, published from 1970 to 05/2009. Median rates and interquartile ranges (IQR) were calculated and compared using non-parametric tests. Demographic and clinical variables were tested as correlates of APP in bivariate and meta-regression analyses.
resultsAcross 147 studies (1,418,163 participants, 82.9% diagnosed with schizophrenia [IQR=42-100%]), the median APP rate was 19.6% (IQR=12.9-35.0%). Most common combinations included first-generation antipsychotics (FGAs)+second-generation antipsychotics (SGAs) (42.4%, IQR=0.0-71.4%) followed by FGAs+FGAs (19.6%, IQR=0.0-100%) and SGAs+SGAs (1.8%, IQR=0.0-28%). APP rates were not different between decades (1970-1979:28.8%, IQR=7.5-44%; 1980-1989:17.6%, IQR=10.8-38.2; 1990-1999:22.0%, IQR=11-40; 2000-2009:19.2% IQR=14.4-29.9, p=0.78), but between regions, being higher in Asia and Europe than North America, and in Asia than Oceania (p<0.001). APP increased numerically by 34% in North America from the 1980s 12.7%) to 2000s (17.0%) (p=0.94) and decreased significantly by 65% from 1980 (55.5%) to 2000 (19.2%) in Asia (p=0.03), with non-significant changes in Europe. APP was associated with inpatient status (p<0.001), use of FGAs (p<0.0001) and anticholinergics (<0.001), schizophrenia (p=0.01), less antidepressant use (p=0.02), greater LAIs use (p=0.04), shorter follow-up (p=0.001) and cross-sectional vs. longitudinal study design (p=0.03). In a meta-regression, inpatient status (p<0.0001), FGA use (0.046), and schizophrenia diagnosis (p=0.004) independently predicted APP (N=66, R(2)=0.44, p<0.0001).
conclusionsAPP is common with different rates and time trends by region over the last four decades. APP is associated with greater anticholinergic requirement, shorter observation time, greater illness severity and lower antidepressant use.
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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.