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Polypharmacy in schizophrenia.
Prakash S Masand1, Haresh M Tharwani, Ashwin A Patkar
1Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, , Durham, NC, USA.
International Journal of Psychiatry in Clinical Practice
|June 19, 2014
Summary
Schizophrenia treatment often involves polypharmacy, using multiple psychotropic medications when single antipsychotics are ineffective. This paper reviews evidence and practical strategies for using adjunctive therapies in complex clinical cases.
Area of Science:
- Psychiatry
- Clinical Pharmacology
Background:
- Research often restricts psychotropic medication use in schizophrenia trials.
- Polypharmacy is prevalent in real-world clinical practice for schizophrenia management.
Purpose of the Study:
- To discuss the prevalence of polypharmacy in schizophrenia.
- To review evidence for adjunctive psychotropic medications in schizophrenia.
- To offer practical suggestions for polypharmacy in challenging clinical settings.
Main Methods:
- Literature review of studies on schizophrenia treatment.
- Analysis of evidence for adjunctive antipsychotics, anticonvulsants, lithium, antidepressants, and benzodiazepines.
- Discussion of clinical practice patterns in schizophrenia management.
Main Results:
- Polypharmacy is common in clinical practice, often due to poor response to antipsychotic monotherapy.
- Evidence supports the adjunctive use of various psychotropic classes.
- Practical strategies for implementing polypharmacy are needed.
Conclusions:
- Polypharmacy is a necessary strategy in many schizophrenia cases.
- Evidence-based guidelines for adjunctive treatments are crucial.
- Practical approaches can optimize polypharmacy for difficult-to-treat schizophrenia patients.
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