ReviewThe international journal of neuropsychopharmacology2020
Antipsychotic Polypharmacy: A Dirty Little Secret or a Fashion?
Review in The international journal of neuropsychopharmacology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 75 citations in OpenAlex.
- Pharmacological Treatment of Alcohol use Disorder in Patients with Psychotic Disorders: A Systematic Review.Current neuropharmacology · 2024Pooled it
- Drug Utilization, Anticholinergic Burden and Predictors of Length of Stay in a Psychiatric Hospital: A Retrospective Observational Study.Medicina (Kaunas, Lithuania) · 2026Observational
- Trends in Antipsychotic Polypharmacy and Potential Overtreatment with Antipsychotics: A Naturalistic Cohort Study of People in Long-term Care.Schizophrenia bulletin · 2026Article
- Article
- Rational antipsychotic polypharmacy in psychotic and bipolar disorders: A focus on D2 receptor partial agonists.The mental health clinician · 2025Article
- The sense and nonsense of antipsychotic combinations: A model for dopamine DTranslational psychiatry · 2025Article
- Attitudes of Australian patients receiving inpatient mental health care towards deprescribing: a cross-sectional survey.BMC psychiatry · 2025Article
- The Potential of Selected Plants and Their Biologically Active Molecules in the Treatment of Depression and Anxiety Disorders.International journal of molecular sciences · 2025Review
- Clinical effectiveness of paliperidone palmitate 3-monthly and 1-monthly as monotherapy in patients with schizophrenia: A retrospective cohort study based on the Medicaid claims database.Neuropsychopharmacology reports · 2024Article
- Antipsychotic prescription patterns among schizophrenia patients in Guangdong Province, China's 686 program: A retrospective study.Medicine · 2024Article
- The management of patients with predominant negative symptoms in Slovakia: A 1-year longitudinal, prospective, multicentric cohort study.European psychiatry : the journal of the Association of European Psychiatrists · 2024Article
- Association of Antipsychotic Polypharmacy and Two-Year All-Cause Mortality: A Population-Based Cohort Study of 33,221 Italian Continuous Users.Journal of clinical medicine · 2024Article
- Non-prescribing of clozapine for outpatients with schizophrenia in real-world settings: The clinicians' perspectives.Schizophrenia (Heidelberg, Germany) · 2023Article
- Effects of Anticholinergic Burden on Verbal Memory Performance in First-Episode Psychosis.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2023Article
- A Case of Antipsychiatry Polypill Overdose (200 Tablets) Successfully Treated With Hemodialysis: A Serious Encounter.Cureus · 2023Article
- Exposure to psychotropic medications and mortality in schizophrenia: a 5-year national cohort study.Psychological medicine · 2023Article
- Chronic Aripiprazole and Trazodone Polypharmacy Effects on Systemic and Brain Cholesterol Biosynthesis.Biomolecules · 2023Article
- Differences in white blood cell proportions between schizophrenia cases and controls are influenced by medication and variations in time of day.Translational psychiatry · 2023Article
- Associations between antipsychotics and the risk of incident cardiovascular diseases in individuals with schizophrenia: a nested case-control study.BMJ mental health · 2023Article
- Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The term polypharmacy was originally coined to refer to problems related to multiple drug consumption and excessive drug use during the treatment of a disease or disorder. In the treatment of schizophrenia, polypharmacy usually refers to the simultaneous use of 2 or more antipsychotic medications or combined (adjunct) medications such as mood stabilizers, antidepressants, anxiolytics, or hypnotics in addition to single or multiple antipsychotics. Two decades ago, antipsychotic polypharmacy was criticized as being more expensive, having unproven efficacy, and causing more side effects. However, in recent years, antipsychotic polypharmacy has become more or less acceptable in the views of clinical practitioners and academic researchers. Results from recent reviews have suggested that the common practice of antipsychotic polypharmacy lacks double-blind or high-quality evidence of efficacy, except for negative symptom reduction with aripiprazole augmentation. We reviewed some representative studies that enrolled large numbers of patients and compared antipsychotic polypharmacy and monotherapy during the past decade. The results revealed that a certain proportion of select patients can benefit from antipsychotic polypharmacy without further negative consequences. Because most of the current treatment guidelines from different countries and organizations prefer monotherapy and discourage all antipsychotic polypharmacy, guidelines regarding the use of antipsychotic polypharmacy in clinical practice should be revised. On the basis of the findings of 2 large-scale studies from Asia and Europe, we also suggest ideal rates of various maintenance treatments of schizophrenia, which are as follows: antipsychotic polypharmacy, 30%; combined mood stabilizer, 15%; combined antidepressant, 10%; combined anxiolytics, 30%; and combined hypnotic, 10%.
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