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Cited by 79Schizophrenia research and treatmentTreatment of Major DepressionMental Health and Psychiatry

Polypharmacy in Schizophrenia

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Baandrup, Lone·2020·Basic & Clinical Pharmacology & Toxicology
DOI 10.1111/bcpt.13384
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Abstract

Schizophrenia is a severe mental disorder characterized by a heterogeneous symptom profile which comprises a clinical platform for widespread use of polypharmacy even though antipsychotic monotherapy is the recommended treatment regimen. This narrative review provides a summary of the current gap between evidence and practice for use of antipsychotic combination therapy in patients with schizophrenia. Antipsychotic polypharmacy is frequently prescribed instead of following international consensus of clozapine monotherapy in treatment‐resistant patients. Antipsychotic‐benzodiazepine combination therapy clearly has a role in the treatment of acute agitation whereas there is no evidence to support an effect on core schizophrenia symptoms when chronically prescribed. Antidepressants are typically added to antipsychotic treatment in case of persistent negative symptoms. Available evidence suggests that antidepressants may improve negative symptom control in schizophrenia. Combining an antipsychotic with an antiepileptic is not supported by any firm evidence, but individual mood stabilizers have come out positively in single trials. Generally, the evidence base for polypharmacy in schizophrenia maintenance treatment is sparse but may be warranted in certain clinical situations. Therapeutic benefits and side effects should be carefully monitored and considered to ensure a beneficial risk‐benefit ratio if prescribing polypharmacy for specific clinical indications.

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Authors
Baandrup, L.
Affiliations
Mental Health Services (DK)
Corresponding author
Baandrup, Lone
ORCID
Baandrup, Lone
Venue
Basic & Clinical Pharmacology & Toxicology
Publisher
Wiley
Published
2020-01-15
Volume
126
Issue
3
Pages
183-192
ISSN
  • 1742-7835 (ISSN-L)
  • 1742-7843
DOI
10.1111/bcpt.13384
OpenAlex
W3000743405
Cited by
79
References
3
Citations by year
2026: 5 · 2025: 14 · 2024: 15 · 2023: 13 · 2022: 14 · 2021: 13 · 2020: 5
FWCI
1.84
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Basic & Clinical Pharmacology & Toxicology (publishedVersion)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
Funders
Lundbeckfonden (R155-2013-16337)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords
schizophrenia, polypharmacy, antipsychotic polypharmacy, treatment-resistant schizophrenia, acute agitation, antidepressants, negative symptoms, antiepileptic drugs, mood stabilizers, maintenance therapy, knowledge-practice gap, adverse effects
MeSH terms
Antidepressive Agents, Benzodiazepines, Drug Therapy, Combination, Humans, Schizophrenia, Antipsychotic Agents, Antimanic Agents, Polypharmacy

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