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Published on: December 11, 2016
Interventions to reduce antipsychotic polypharmacy: a systematic review.
Hideaki Tani1, Hiroyuki Uchida, Takefumi Suzuki
1Department of Psychiatry, Yamanashi Prefectural Kita Hospital, Yamanashi, Japan.
Schizophrenia Research
|November 20, 2012
Summary
Reducing antipsychotic polypharmacy in schizophrenia is challenging. Switching to monotherapy is feasible for many patients, and assertive interventions are more effective than educational approaches alone.
Area of Science:
- Psychiatry
- Clinical Pharmacology
Background:
- Antipsychotic polypharmacy, the use of multiple antipsychotics, is common but controversial in schizophrenia treatment.
- Strategies to counteract or reduce antipsychotic polypharmacy remain unclear.
Purpose of the Study:
- To synthesize existing clinical evidence on methods to reduce antipsychotic polypharmacy in schizophrenia patients.
Main Methods:
- A comprehensive literature search was conducted across major databases (PubMed, MEDLINE, EMBASE, PsycINFO) up to June 2012.
- Search terms included "antipsychotics" and "polypharmacy"; cross-referencing was also performed.
Main Results:
- Only 3 studies systematically switched patients from antipsychotic polypharmacy to monotherapy, with successful completion rates ranging from 42.9% to 77.3%.
- Fourteen studies examined interventions to reduce antipsychotic polypharmacy; assertive interventions were more effective (10/12 studies) than passive educational approaches (3/5 studies).
Conclusions:
- Data on reducing antipsychotic polypharmacy is limited.
- Switching from antipsychotic polypharmacy to monotherapy appears feasible for most schizophrenia patients.
- Assertive interventions show greater efficacy in reducing antipsychotic polypharmacy compared to educational methods alone.
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