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Is Rational Antipsychotic Polytherapy Feasible? A Selective Review

  • SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS (SJ SIEGEL, SECTION EDITOR)
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Abstract

Antipsychotic polytherapy (APT) has evolved as a common treatment strategy at odds with recommendations from schizophrenia treatment guidelines. The literature on combinations with clozapine as a means to enhance efficacy and with aripiprazole to reduce side effects was reviewed. No solid evidence supporting antipsychotic combinations with clozapine for treatment-resistant patients with schizophrenia was identified. The reason for this may be that most combinations with clozapine increase the D2-receptor blockade, and this strategy is probably not efficient for patients with treatment-resistant schizophrenia. Some basic and clinical evidence for the addition of aripiprazole to lower prolactin levels was identified. In conclusion, there is very limited support in the evidence for the feasibility of rational APT.

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Disclosure

Dr. Kroken has been reimbursed for attending conferences by Eli Lilly and Company, Bristol-Myers Squibb, Janssen-Cilag, and Lundbeck.

Dr. Johnsen has received honoraria from Bristol-Myers Squibb (for lectures given in meetings), Eli Lilly and Company (for lectures given in meetings and contributions to an information brochure), and AstraZeneca (for lectures given in meetings) and has had travel/accommodations expenses reimbursed for attending conferences by Eli Lilly and Company and Janssen-Cilag.

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  1. Division of Psychiatry, Haukeland University Hospital, Pb 23, 5812, Bergen, Norway

    Rune Andreas Kroken & Erik Johnsen

  2. Department of Clinical Medicine, Section of Psychiatry, University of Bergen, Pb 23, 5812, Bergen, Norway

    Erik Johnsen

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  1. Rune Andreas Kroken
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Correspondence to Rune Andreas Kroken.

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Kroken, R.A., Johnsen, E. Is Rational Antipsychotic Polytherapy Feasible? A Selective Review. Curr Psychiatry Rep 14, 244–251 (2012). https://doi.org/10.1007/s11920-012-0266-y

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