Antipsychotic polypharmacy: Is there evidence for its use?

Journal of Psychiatric Practice

Volumn 11, Issue 4, 2005, Pages 248-257

  Patrick, Vijayalakshmy ^a,b   Levin, Elizabeth ^a   Schleifer, Steven ^a  

^a RUTGERS NEW JERSEY MEDICAL SCHOOL   (United States)

^b NONE   (United States)

Author keywords

Antipsychotic polypharmacy; Case reports; Case series; Double blind placebo controlled studies; Open label clinical trials

Indexed keywords

CHLORPROMAZINE; CLOZAPINE; DROPERIDOL; FLUPHENAZINE DECANOATE; HALOPERIDOL; LEVOMEPROMAZINE; LOXAPINE; NEUROLEPTIC AGENT; OLANZAPINE; PERAZINE; PERPHENAZINE; PIMOZIDE; PRAMIPEXOLE; QUETIAPINE; RESERPINE; RISPERIDONE; SULPIRIDE; THIORIDAZINE; TIOTIXENE; TRIFLUOPERAZINE;

CASE REPORT; CLINICAL TRIAL; DOUBLE BLIND PROCEDURE; DRUG EFFICACY; DRUG USE; EVIDENCE BASED MEDICINE; HUMAN; MEDLINE; METHODOLOGY; MONOTHERAPY; OPEN STUDY; POLYPHARMACY; PSYCHOSIS; REVIEW;

ANTIPSYCHOTIC AGENTS; CONTROLLED CLINICAL TRIALS; DOUBLE-BLIND METHOD; DRUG THERAPY, COMBINATION; HUMANS; PSYCHOTIC DISORDERS; TREATMENT OUTCOME;

EID: 23744454716     PISSN: 15274160     EISSN: None     Source Type: Journal    
DOI: 10.1097/00131746-200507000-00005     Document Type: Review

References (76)

1. Buckley P, Miller A, Olsen J, et al. When symptoms persist: Clozapine augmentation strategies. Schizophr Bull 2001;27:615-28.
2. Wilson WH, Ban TA, Guy W. Pharmacotherapy of chronic hospitalized schizophrenics: Prescription practices. Pharmacopsychiatry 1985;14:75-82.
3. Sheppard C, Collins L, Fiorentino D, et al. Polypharmacy in psychiatric treatment: Incidence at a state hospital. Curr Ther Res Clin Exp 1969;11:765-73.
4. Hemminki E. Polypharmacy among psychiatric patients. Acta Psychiatr Scand 1977;56:347-56.
5. Tapp A, Wood AE, Secrest L, et al. Combination antipsychotic therapy in clinical practice. Psychiatr Serv 2003;54:55-9.
6. Procyshyn RM, Kennedy NB, Tse G. Antipsychotic polypharmacy: A survey of discharge prescriptions from a tertiary care psychiatric institution. Can J Psychiatry 2001;46:334-9.
7. Muijen M, Silverstone T. A comparative hospital survey of psychotropic drug prescribing. Br J Psychiatry 1987;150:501-4.
8. Stahl SM. Antipsychotic polypharmacy: Squandering precious resources? J Clin Psychiatry 2002;63:93-4.
9. Kingsbury SJ, Yi D, Simpson GM. Rational and irrational polypharmacy: Psychiatr Serv 2001;52:1033-6.
10. Stahl SM, Simon-Leack, Walker V. Developing an educational program to reduce costs of atypical antipsychotics in the California Medicaid program without imposing formulary restrictions. Presented at the 23rd Congress of the College of International Neuropsychopharmacology; June 23-27, 2002: Montreal, Canada.
11. Stern RG, Schmeidler J, Davidson M. Limitations of controlled augmentation trials in schizophrenia. Biol Psychiatry 1997;42:138-43.
12. Preskorn SH, Lacey RL. Polypharmacy: When is it rational? Journal of Practical Psychiatry and Behavioral Health 1995;1:92-8.
13. Taylor CG, Flynn SW, Altman S, et al. An open trial of risperidone augmentation of partial response to clozapine. Schizophr Research 2001;48:155-8.
14. Raju GVL, Ramesh Kumar TC, Khanna S. Clozapine-risperidone combination in treatment-resistant schizophrenia. Aust N Z J Psychiatry 2001;35:543.
15. Morera AL, Barreiro P, Canno-Munoz JL. Risperidone and clozapine combination for the treatment of refractory schizophrenia. Acta Psychiatr Scand 1999;99:305-7.
16. Shiloh R, Zemishlany Z, Aizenberg D, et al. Sulpiride augmentation in people with schizophrenia partially responsive to clozapine: A double-blind, placebo-controlled study. Br J Psychiatry 1997;171:569-73.
17. Potter WZ, Ko GN, Zhang LD, et al. Clozapine in China: A review and preview of US/PRC collaboration. Psychopharmacology 1989;99:S87-S91.
18. Nishikawa T, Tsuda A, Tanaka M, et al. Prophylactic effects of neuroleptics in symptom-free schizophrenics: Roles of dopaminergic and noradrenergic blockers. Biol Psychiatry 1985;20:1161-6.
19. Knight RG, Harrison A. A double-blind comparison of thiothixene and a trifluoperazine/chlorpromazine composite in the treatment of schizophrenia. N Z Med J 1979;89:302-4.
20. de Groot IW, Heck AH, Van Harten PN. Addition of risperidone to clozapine therapy in chronically psychotic inpatients. J Clin Psychiatry 2001;62:129-30.
21. Henderson DC, Goff DC. Risperidone as an adjunct to clozapine therapy in chronic schizophrenics. J Clin Psychiatry 1996;57:395-7.
22. Lerner V, Chudakova B, Kravets S, et al. Combined use of risperidone and olanzapine in the treatment of patients with resistant schizophrenia: A preliminary case series report. Clin Neuropharmacol 2000;23:284-6.
23. Raskin S, Durst R, Katz G, et al. Olanzapine and sulpiride: A preliminary study of combination/augmentation in patients with treatment resistant schizophrenia. J Clin Psychopharmacol 2000;20:500-3.
24. Friedman J, Ault K, Powchik P. Pimozide augmentation for the treatment of schizophrenic patients who are partial responders to clozapine. Biol Psychiatry 1997;42:522-3.
25. Kasper S, Barnas C, Heiden A, et al. Pramipexole as adjunct to haloperidol in schizophrenia: Safety and efficacy. Eur Neuropsychopharmacol 1997;7:65-70.
26. Mowerman S, Siris SG. Adjunctive loxapine in a clozapine resistant cohort of schizophrenic patients. Ann Clin Psychiatry 1996;8:193-7.
27. Bacher NM, Kaup BA. Combining risperidone with standard neuroleptics for refractory schizophrenic patients. Am J Psychiatry 1996;53:137.
28. Shiloh R, Zemishlany Z, Aizenberg D, et al. Sulpiride adjunction to clozapine in treatment-resistant schizophrenic patients: A preliminary case series study. Eur Psychiatry 1997;12:152-5.
29. Henderson DC, Goff DC, Connolly CE, et al. Risperidone added to clozapine: Impact on serum prolactin levels. J Clin Psychiatry 2001;62:605-8.
30. Reinstein MJ, Sirotovskaya LA, Jones LE, et al. Effects of clozapine-quetiapine combination therapy on weight and glycaemic control. Clinical Drug Investigations 1999;18:99-104.
31. Potkin SG, Thyrum PT, Alva G, et al. The safety and pharmacokinetics of quetiapine when coadministered with haloperidol, risperidone or thioridazine. J Clin Psychopharmacol 2002;22:121-30.
32. Adesanya A, Pantelis C. Adjunctive risperidone treatment in patients with "clozapine-resistant schizophrenia." Aust N Z J Psychiatry 2000;34:533-4.
33. Raskin S, Katz G, Zislin Z, et al. Clozapine and risperidone: Combination/augmentation treatment of refractory schizophrenia: A preliminary observation. Acta Psychiatr Scand 2000;101:334-6.
34. McCarthy RH, Terkelsen KG. Risperidone augmentation of clozapine. Pharmacopsychiatry 1995;28:61-3.
35. Tyson SC, Devane CL, Risch SC. Pharmacokinetic interaction between risperidone and clozapine. Am J Psychiatry 1995;152:1401-2.
36. Chong SA, Tan CH, Lee HS. Atrial ectopics with clozapine-risperidone combination. J Clin Psychopharmacol 1997;17:130-1.
37. Chong SA, Tan CH, Lee HS. Hoarding and clozapine-risperidone combination. Can J Psychiatry 1996;41:315-6.
38. Godleski LS, Sernyak MJ. Agranulocytosis after addition of risperidone to clozapine treatment. Am J Psychiatry 1996;153:735-6.
39. Beauchemin MA, Millaud F, Nguyen KA. A case of neuroleptic malignant syndrome with clozapine and risperidone. Can J Psychiatry 2002;47:886.
40. Kontaxakis VP, Havaki-Kontaxaki BJ, Stamouli SS, et al. Toxic interaction between risperidone and clozapine; A case report. Prog Neuropsychopharmacol Biol Psychiatry 2002;26:407-9.
41. Koreen AR, Lieberman JA, Kronig M, et al. Cross-tapering clozapine and risperidone. Am J Psychiatry 1995;152:1690.
42. Terao T, Kojima H. Risperidone addition and psychotic exacerbation. J Neuropsychiatry Clin Neurosci 2001;13:114-5.
43. Cooke C, de Leon J. Adding other antipsychotics to clozapine. J Clin Psychiatry 1999;60:710.
44. Chue P, Welch R, Snaterse M. Combination risperidone and quetiapine therapy in refractory schizophrenia. Can J Psychiatry 2001;46:86-7.
45. Stubbs JH, Haw CM, Staley CJ, et al. Augmentation with sulpiride for a schizophrenic patient partially responsive to clozapine. Acta Psychiatr Scand 2000;102:390-4.
46. Rhoads E. Polypharmacy of 2 atypical antipsychotics. J Clin Psychiatry 2000;61:678-9.
47. Takhar J. Pimozide augmentation in a patient with drug-resistant psychosis previously treated with olanzapine. J Psychiatry Neurosci 1999;24:248-9.
48. Gupta S, Sonnenberg SJ, Frank B. Olanzapine augmentation of clozapine. Ann Clin Psychiatry 1998;10:113-5.
49. Healy DJ, Dalack GW, Meador-Woodruff JH. Clozapine-reserpine combination for refractory psychosis. Schizophr Res 1997;25:259-60.
50. Solon EN. Risperidone-reserpine combination in refractory psychosis. Schizophr Res 1996;22:265-6.
51. Bauer M. Concurrent agranulocytosis and acute hepatitis resulting from combination of classic neuroleptics and subsequent successful clozapine treatment. Pharmacopsychiatry 1995;28:29-31.
52. Peacock L, Gerlach J. Clozapine treatment in Denmark: Concomitant psychotropic medication and hematologic monitoring in a system with liberal usage practices. J Clin Psychiatry 1994;55:44-9.
53. Young A, Kehoe R. Two cases of agranulocytosis on addition of a butyrophenone to a long standing course of phenothiazine treatment. Br J Psychiatry 1989;154:710-2.
54. Diaz P, Hogan TP. Granulocytopenia with clozapine and quetiapine. Am J Psychiatry 2001;158:651.
55. Mujica R, Weiden P. Neuroleptic malignant syndrome after addition of haloperidol to atypical antipsychotic. Am J Psychiatry 2001;158:650-1.
56. Jarventausta K, Leinonen E. Neuroleptic malignant syndrome during olanzapine and levomepromazine treatment. Acta Psychiatr Scand 2000;102:231-3.
57. Teo SK, Sin Fai Lam KN, Chew WLS. A fulminant case of neuroleptic malignant syndrome. Singapore Med J 1994;35:110-1.
58. Stanley AK, Hunter J. Possible neuroleptic malignant syndrome with quetiapine. Br J Psychiatry 2000;176:497.
59. Seger A, Lamberti JS. Priapism associated with polypharmacy. J Clin Psychiatry 2001;62:128.
60. Allen SA. Effect of chlorpromazine and clozapine on plasma concentrations of haloperidol in a patient with schizophrenia. J Clin Pharmacol 2000;40:1296-7.
61. Larrey D, Lainey E, Blanc P, et al. Acute colitis associated with prolonged administration of neuroleptics. J Clin Gastroenterol 1992;14:64-7.
62. Haberfellner EM. Myoclonic and generalized tonic clonic seizures during combined treatment with low doses of clozapine and haloperidol. Eur Psychiatry 2002;17:55-6.
63. Hedges DW, Jeppson KG. New onset seizure associated with quetiapine and olanzapine. Ann Pharmacother 2002;36:437-8.
64. Grohmann R, Ruther E, Sassim N, et al. Adverse effects of clozapine. Psychopharmacology 1989;99:S101-4.
65. Kay SR, Fiszbein A, Opler LA. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull 1987;13:261-76.
66. Guy W. ECDEU assessment manual for psychopharmacology-revised (DHEW Publ. No ADM 76-338). Rockville, MD, U.S. Department of Health, Education, and Welfare, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, NIMH Psychopharmacology Research Branch, Division of Extramural Research Programs 1976:218-22.
67. Overall JE, Gorham DR. The Brief Psychiatric Rating Scale (BPRS): Recent developments in ascertainment and scaling. Psychopharmacol Bull 1988;24:97-9.
68. Andreasen N. Scale for the Assessment of Positive Symptoms (SANS). Iowa City, IA: University of Iowa; 1984.
69. Hamilton M. Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 1967;6:278-96.
70. Andreasen N. Scale for the Assessment of Negative Symptoms (SANS). Iowa City, IA: University of Iowa; 1983.
71. Chouinard G, Ross-Chouinard A, Annable L, et al. Extrapyramidal Rating Scale. Can J Neurol Sci 1980;7:233-9.
72. Addington D, Addington J, Schissel B. A depression rating scale for schizophrenics. Schizophr Res 1990;3:247-51.
73. Guy W. ECDEU assessment manual for psychopharmacology-revised (DHEW Publ. No ADM 76-338). Rockville, MD, U.S. Department of Health, Education, and Welfare, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, NIMH Psychopharmacology Research Branch, Division of Extramural Research Programs 1976:534-7.
74. Lerner V, Libov I, Kotler M, et al. Combination of "atypical" antipsychotic medication in the management of treatment-resistant schizophrenia and schizoaffective disorder. Prog Neuropsychopharmacol Biol Psychiatry 2004;28:89-98.
75. Zervas IM, Mantonakis I, Kattan K. Risperidone-clozapine combination for refractory schizophrenia. Eur Neuropsychopharmacol 1998;8:S37.
76. Mantonakis I, Kattan K, Zervas IM. Risperidone augmentation of clozapine and olanzapine for refractory schizophrenia. Eur Neuropsychopharmacol 1998;8:S233.