Is multidrug therapy safe in the treatment of schizophrenia?

Updated: Mar 16, 2018
  • Author: Frances R Frankenburg, MD; Chief Editor: Glen L Xiong, MD  more...
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Answer

If the patient has not responded to a medication, physicians can switch medications or add another one. Using 2 or even 3 different antipsychotic agents together is common, though this practice lacks a compelling evidence base and does increase the complexity of the medication regimen.

Nonetheless, in one large study, discontinuance of 1 of 2 antipsychotics was followed by treatment discontinuance more often and more quickly than continuation of both antipsychotics were continued. [94] A meta-analysis of 19 studies involving more than 1200 subjects found a modest advantage for antipsychotic polypharmacy. [95]

Physicians sometimes choose what seems to be a simpler option than switching or adding medication, which is to increase the dose of the original medication. For example, quetiapine is sometimes prescribed at higher than approved doses for patients with schizophrenia or schizoaffective disorder. Honer et al found that dosages higher than 800 mg/day did not show any advantage over dosages in the approved range. [96]


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