ArticleExpert opinion on drug safety2012
Safety and tolerability of antipsychotic polypharmacy.
Article in Expert opinion on drug safety, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 83 papers, 5 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
83 citing papers in PubMed, 5 syntheses or guidelines pooled it, 204 citations in OpenAlex.
- Cariprazine and clozapine: a systematic review of a promising antipsychotic combination for treatment-resistant schizophrenia.The international journal of neuropsychopharmacology · 2025Pooled it
- Risk Factors for Psychotic Relapse After Dose Reduction or Discontinuation of Antipsychotics in Patients With Chronic Schizophrenia. A Meta-Analysis of Randomized Controlled Trials.Schizophrenia bulletin · 2023Pooled it
- [Schizophrenia and bipolar disorder : Treatment of cognitive impairments].Der Nervenarzt · 2018Pooled it
- Antipsychotic Polypharmacy and Corrected QT Interval: A Systematic Review.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2015Pooled 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
- Asenapine add-on treatment for schizophrenia adults who received antipsychotics: A 52-week, open-label study.Psychiatry and clinical neurosciences · 2023Trial
- Combination Antipsychotic Therapies: An Analysis From a Longitudinal Pragmatic Trial.Journal of clinical psychopharmacology · 2017Trial
- Prolactin related symptoms during risperidone maintenance treatment: results from a prospective, multicenter study of schizophrenia.BMC psychiatry · 2016Trial
- Investigating the relationship between Toll-like receptor activity, low-grade inflammation, cognitive deficits, and antipsychotic drug dose in schizophrenia patients: a moderation analysis.Psychological medicine · 2026Article
- The prevalence of antipsychotic polypharmacy and its associations with violent behaviors among forensic psychiatry patients.BMC psychiatry · 2026Article
- Managing schizophrenia with affective, sexual, metabolic and substance-use comorbidities: pharmacological considerations from an expert consensus.Annals of general psychiatry · 2025Article
- The influence of social capital and evidence-based orientation on psychiatrists' attitudes toward antipsychotic polypharmacy in schizophrenia.Scientific reports · 2025Article
- Antipsychotic load during olanzapine mono- versus polytherapy and in relation to age.European journal of clinical pharmacology · 2025Article
- Factors associated with treatment failure after discharge in inpatients with schizophrenia spectrum disorders: A retrospective observational study.PCN reports : psychiatry and clinical neurosciences · 2025Article
- Article
- Attitudes of Australian patients receiving inpatient mental health care towards deprescribing: a cross-sectional survey.BMC psychiatry · 2025Article
- A Pharmacovigilance Study on Clozapine in the Food and Drug Administration Adverse Event Reporting System: A Regional Comparative Analysis.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2024Article
- Article
- A systematic review and meta-analysis of the effects of combined aripiprazole on glycolipid metabolism in schizophrenia.Frontiers in psychiatry · 2024Review
- Case report: Avoiding intolerance to antipsychotics through a personalized treatment approach based on pharmacogenetics.Frontiers in psychiatry · 2024Article
23 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 4 institutions in 2 countries.
Funding
Abstract
introductionAntipsychotic polypharmacy (APP), the concomitant use of ≥ 2 antipsychotics, is common in clinical practice. Prior reviews have focused on the efficacy of APP, but no systematic review exists regarding the safety and tolerability of this practice. AREAS COVERED: A systematic review of adverse effects associated with APP was conducted to prepare this review; case series with ≥ 2 patients, chart reviews, naturalistic, database, cohort and randomized studies that reported on the association between APP in general or specific APP combinations and global or specific adverse effect were included. Methodological limitations of available studies are discussed and recommendations for clinicians and future research are provided. EXPERT OPINION: Across mostly small and uncontrolled studies, APP has been associated with increased global side effect burden, rates of Parkinsonian side effects, anticholinergic use, hyperprolactinemia, sexual dysfunction, hypersalivation, sedation/somnolence, cognitive impairment and diabetes. Effects on akathisia and mortality were inconclusive. Although some combinations, particularly aripiprazole augmentation of an agent with greater side effect burden, may reduce weight gain, dyslipidemia, hyperprolactinemia and sexual dysfunction, APP should remain a last-resort treatment option after monotherapy, switching and non-antipsychotic combinations have failed. More data are needed to further inform the individualized risk-benefit evaluation of APP.
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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.