Despite a lack of extensive evidence or clinical guidance from authorities within the psychiatric community, antipsychotic polypharmacy is often utilized as a treatment strategy in schizophrenia. Currently, of the six major clinical guidelines in schizophrenia, five recommend polypharmacy involving clozapine and another antipsychotic, but only as a last line effort after monotherapy has failed multiple times.
These polypharmacy recommendations are often weak and leave much to the individual practitioner. Additionally, these standards are not always strictly adhered to, and patients are often introduced to multiple antipsychotic combinations that either have little evidence or have been initiated during an inappropriate early treatment period.
Furthermore, rates and descriptions of polypharmacy vary greatly. This lack of continuity describing incidences of multiple antipsychotics, and a lack of evidence concerning common combinations and strategies, leave many practitioners in the dark and creates an atmosphere of inconsistency within the psychiatric community.
This practical reference examines the advantages and disadvantages of polypharmacy in psychiatry, and provides up-to-date clinical guidelines on the appropriate use of combinations of pharmacological therapy in major psychiatric disorders-including multidisciplinary approaches to treatment, such as social work and psychopharmacology, and an examination of the psychotherapeutic and historical aspects of polypharmacy.