Revising polypharmacy to a single antipsychotic regimen for patients with chronic schizophrenia

Takefumi Suzuki, Hiroyuki Uchida, Kenji Tanaka, Kensuke Nomura, Harumasa Takano, Akira Tanabe, Koichiro Watanabe, Gohei Yagi, Haruo Kashima

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Antipsychotic polypharmacy has been empirically used and a recent trend in favour of that mode of therapy has been suggested for the treatment of schizophrenia. The clinical efficacy, however, still remains to be clarified. In order to critically evaluate the usefulness of such kind of psychopharmacotherapy, antipsychotic combination regimen (polypharmacy) was switched to a treatment with the single main antipsychotic (monotherapy) in cross-tapered fashion, while approximately maintaining the total amount, for patients with chronic schizophrenia. Patients had been treated with an average of three antipsychotics and maintained with the same antipsychotic polypharmacy regimen for more than 6 months before the entry. They were followed up with an antipsychotic monopharmacy and evaluated at 24 wk after completion of switching. Forty-seven patients were recruited for this study. Of 44 patients for whom evaluation was possible, 24 (54.5%) remained stable, while 10 (22.7%) showed improvement and the same number of patients ended in a deleterious status. Twenty-two patients were converted to antipsychotic monotherapy, while another 12 needed minimal dosing of low-potency agents. Overall, social functioning, evaluated by the Global Assessment of Functioning and the Clinical Global Impression, remained unchanged. Eighteen of 34 successful patients showed adverse effects of the main antipsychotic medication, which necessitated a significant dose reduction. Nine out of 10 deteriorating patients had been treated with a combination of low- and high-potency antipsychotics. It is suggested that many instances of antipsychotic polypharmacy is avoidable. The result is compatible with the current treatment recommendations, which dictate the use of a single antipsychotic agent.

Original languageEnglish
Pages (from-to)133-142
Number of pages10
JournalInternational Journal of Neuropsychopharmacology
Volume7
Issue number2
DOIs
Publication statusPublished - 2004 Jun

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Polypharmacy
Antipsychotic Agents
Schizophrenia
Therapeutics

Keywords

  • Antipsychotics
  • Monotherapy
  • Polypharmacy
  • Schizophrenia

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Neuropsychology and Physiological Psychology
  • Neuroscience(all)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Revising polypharmacy to a single antipsychotic regimen for patients with chronic schizophrenia. / Suzuki, Takefumi; Uchida, Hiroyuki; Tanaka, Kenji; Nomura, Kensuke; Takano, Harumasa; Tanabe, Akira; Watanabe, Koichiro; Yagi, Gohei; Kashima, Haruo.

In: International Journal of Neuropsychopharmacology, Vol. 7, No. 2, 06.2004, p. 133-142.

Research output: Contribution to journalArticle

Suzuki, Takefumi ; Uchida, Hiroyuki ; Tanaka, Kenji ; Nomura, Kensuke ; Takano, Harumasa ; Tanabe, Akira ; Watanabe, Koichiro ; Yagi, Gohei ; Kashima, Haruo. / Revising polypharmacy to a single antipsychotic regimen for patients with chronic schizophrenia. In: International Journal of Neuropsychopharmacology. 2004 ; Vol. 7, No. 2. pp. 133-142.
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