ReviewFrontiers in psychiatry2026
Prevalence of antipsychotic polypharmacy in patients with schizophrenia and other psychotic disorders in the MENAT and EMRO countries: a systematic review and meta-analysis.
Review in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Antipsychotic monotherapy is considered the standard for schizophrenia treatment. However, many patients with schizophrenia and other psychotic disorders receive antipsychotic polypharmacy (APP). This can be associated with increased adverse effects, drug interactions, and treatment costs. This review aims to synthesize evidence on the prevalence of APP in the Middle East, North Africa, Turkey, and the Eastern Mediterranean (MENAT/EMRO) countries. Eight databases were systematically searched for studies published up to February 2026 that reported APP prevalence among patients with schizophrenia and psychotic disorders in MENAT and EMRO countries. The methodological quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist, while the overall certainty of evidence was evaluated using GRADE conceptual approach (Grading of Recommendations Assessment, Development and Evaluation). The pooled prevalence was estimated using random-effects meta-analysis, and statistical heterogeneity was assessed using tau-squared (τ²) and I² statistic. Potential sources of heterogeneity were explored through subgroup and meta-regression analyses, and publication bias was assessed using funnel plots and Egger's tests. Seventeen studies with 6,053 individuals with schizophrenia and other psychotic disorders were included. The pooled prevalence of APP was 50% (95% CI: 37%-62%), with substantial heterogeneity (I² = 98.4%), and was commonly associated with second-generation antipsychotics. Evidence linking APP to specific demographic and clinical variables was limited to a few studies, which found APP associated with higher number of hospitalizations. A pooled prevalence across nine of the APP studies revealed that only 12% (95% CI: 8% to 18%) were receiving clozapine. APP is highly prevalent in MENAT/EMRO countries. Given the potential harms of polypharmacy and the limited evidence supporting it, we recommend efforts to reduce APP and increase clozapine utilization among eligible patients. Evidence-based guidelines, clinician training, and improved clozapine accessibility are crucial to optimizing schizophrenia management in the region.
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.