Prevalence and correlates of antipsychotic polypharmacy: A systematic review and meta-regression of global and regional trends from the 1970s to 2009

Schizophrenia Research

Volumn 138, Issue 1, 2012, Pages 18-28

  Gallego, Juan A ^a,e   Bonetti, John ^b   Zhang, Jianping ^a   Kane, John M ^a,c,d,e  

^a ZUCKER HILLSIDE HOSPITAL   (United States)

^b INSTITUTE OF LIVING   (United States)

^c ALBERT EINSTEIN COLLEGE OF MEDICINE   (United States)

^d DONALD AND BARBARA ZUCKER SCHOOL OF MEDICINE AT HOFSTRA NORTHWELL   (United States)

^e FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH   (United States)

Author keywords

Combinations; Cotreatment; Meta regression; Polypharmacy; Schizophrenia

Indexed keywords

NEUROLEPTIC AGENT;

ADULT; DISEASE SEVERITY; DRUG USE; FEMALE; FOLLOW UP; GEOGRAPHIC DISTRIBUTION; HUMAN; MAJOR CLINICAL STUDY; MALE; META ANALYSIS; POLYPHARMACY; PRIORITY JOURNAL; REVIEW; SCHIZOPHRENIA; STUDY DESIGN; SYSTEMATIC REVIEW; TREATMENT DURATION; TREND STUDY;

ANTIPSYCHOTIC AGENTS; ASIA; DRUG THERAPY; DRUG THERAPY, COMBINATION; EUROPE; HUMANS; NORTH AMERICA; OCEANIA; POLYPHARMACY; SCHIZOPHRENIA;

EID: 84861531195     PISSN: 09209964     EISSN: 15732509     Source Type: Journal    
DOI: 10.1016/j.schres.2012.03.018     Document Type: Review

References (176)

1. Advokat C., Dixon D., Schneider J., Comaty J.E. Comparison of risperidone and olanzapine as used under "real-world" conditions in a state psychiatric hospital. Prog. Neuropsychopharmacol. Biol. Psychiatry 2004, 28(3):487-495.
2. Ahn J., McCombs J.S., Jung C., Croudace T.J., McDonnell D., Ascher-Svanum H., Edgell E.T., Shi L. Classifying patients by antipsychotic adherence patterns using latent class analysis: characteristics of nonadherent groups in the California Medicaid (Medi-Cal) program. Value Health 2008, 11(1):48-56.
3. Ambuhl B., Wurmle O., Michel K. Prescribing practice of psychotropic drugs in a psychiatric university clinic. Psychiatr. Prax. 1993, 20(2):70-73.
4. Ananth J., Parameswaran S., Gunatilake S. Antipsychotic polypharmacy. Curr. Pharm. Des. 2004, 10(18):2231-2238.
5. Andersen S.E., Johansson M., Manniche C. The prescribing pattern of a new antipsychotic: a descriptive study of aripiprazole for psychiatric in-patients. Basic Clin. Pharmacol. Toxicol. 2008, 103(1):75-81.
6. Anderson D.N. A comparison of in-patient and out-patient prescribing. Br. J. Psychiatry 1989, 154:644-649.
7. Baldessarini R.J., Kando J.C., Centorrino F. Hospital use of antipsychotic agents in 1989 and 1993: stable dosing with decreased length of stay. Am. J. Psychiatry 1995, 152(7):1038-1044.
8. Ballerini A., Boccalon R.M., Boncompagni G., Casacchia M., Margari F., Minervini L., Righi R., Russo F., Salteri A., Frediani S., Rossi A., Scatigna M. Clinical features and therapeutic management of patients admitted to Italian acute hospital psychiatric units: the PERSEO (psychiatric emergency study and epidemiology) survey. Annu. Gen. Psychiatry 2007, 6(1):29.
9. Barbui C., Nose M., Mazzi M.A., Bindman J., Leese M., Schene A., Becker T., Angermeyer M.C., Koeter M., Gray R., Tansella M. Determinants of first- and second-generation antipsychotic drug use in clinically unstable patients with schizophrenia treated in four European countries. Int. Clin. Psychopharmacol. 2006, 21(2):73-79.
10. Barbui C., Nose M., Mazzi M.A., Thornicroft G., Schene A., Becker T., Bindman J., Leese M., Helm H., Koeter M., Weinmann S., Tansella M. Persistence with polypharmacy and excessive dosing in patients with schizophrenia treated in four European countries. Int. Clin. Psychopharmacol. 2006, 21(6):355-362.
11. Barbui C., Signoretti A., Mule S., Boso M., Cipriani A. Does the addition of a second antipsychotic drug improve clozapine treatment?. Schizophr. Bull. 2009, 35(2):458-468.
12. Biancosino B., Barbui C., Marmai L., Dona S., Grassi L. Determinants of antipsychotic polypharmacy in psychiatric inpatients: a prospective study. Int. Clin. Psychopharmacol. 2005, 20(6):305-309.
13. Bingefors K., Isacson D., Lindstrom E. Dosage patterns of antipsychotic drugs for the treatment of schizophrenia in Swedish ambulatory clinical practice-a highly individualized therapy. Nord. J. Psychiatry 2003, 57(4):263-269.
14. Bitter I., Chou J.C., Ungvari G.S., Tang W.K., Xiang Z., Iwanami A., Gaszner P. Prescribing for inpatients with schizophrenia: an international multi-center comparative study. Pharmacopsychiatry 2003, 36(4):143-149.
15. Botts S., Hines H., Littrell R. Antipsychotic polypharmacy in the ambulatory care setting, 1993-2000. Psychiatr. Serv. 2003, 54(8):1086.
16. Brayley J., Rafalowicz E., Yellowlees P. Psychotropic drug prescribing in a general hospital inpatient psychiatric unit. Aust. N.Z. J. Psychiatry 1989, 23(3):352-356.
17. Broekema W.J., de Groot I.W., van Harten P.N. Simultaneous prescribing of atypical antipsychotics, conventional antipsychotics and anticholinergics-a European study. Pharm. World Sci. 2007, 29(3):126-130.
18. Brunot A., Lachaux B., Sontag H., Casadebaig F., Philippe A., Rouillon F., Clery-Melin P., Hergueta T., Llorca P.M., Moreaudefarges T., Guillon P., Lebrun T. Pharmaco-epidemiological study on antipsychotic drug prescription in French psychiatry: patient characteristics, antipsychotic treatment, and care management for schizophrenia. Encephale 2002, 28(2):129-138.
19. Buckley P., Miller A., Olsen J., Garver D., Miller D.D., Csernansky J. When symptoms persist: clozapine augmentation strategies. Schizophr. Bull. 2001, 27(4):615-628.
20. Carnahan R.M., Lund B.C., Perry P.J., Chrischilles E.A. Increased risk of extrapyramidal side-effect treatment associated with atypical antipsychotic polytherapy. Acta Psychiatr. Scand. 2006, 113(2):135-141.
21. Castberg I., Spigset O. Prescribing patterns and the use of therapeutic drug monitoring of psychotropic medication in a psychiatric high-security unit. Ther. Drug Monit. 2008, 30(5):597-603. PubMed PMID:18708990 (Oct).
22. Castle D., Morgan V., Jablensky A. Antipsychotic use in Australia: the patients' perspective. Aust. N.Z. J. Psychiatry 2002, 36(5):633-641.
23. Catalan J., Gath D.H., Bond A., Edmonds G., Martin P., Ennis J. General practice patients on long-term psychotropic drugs. A controlled investigation. Br. J. Psychiatry 1988, 152(3):399-405.
24. Centorrino F., Eakin M., Bahk W.M., Kelleher J.P., Goren J., Salvatore P., Egli S., Baldessarini R.J. Inpatient antipsychotic drug use in 1998, 1993, and 1989. Am. J. Psychiatry 2002, 159(11):1932-1935.
25. Centorrino F., Goren J.L., Hennen J., Salvatore P., Kelleher J.P., Baldessarini R.J. Multiple versus single antipsychotic agents for hospitalized psychiatric patients: case-control study of risks versus benefits. Am. J. Psychiatry 2004, 161(4):700-706.
26. Centorrino F., Cincotta S.L., Talamo A., Fogarty K.V., Guzzetta F., Saadeh M.G., Salvatore P., Baldessarini R.J. Hospital use of antipsychotic drugs: polytherapy. Compr. Psychiatry 2008, 49(1):65-69.
27. Chakos M.H., Glick I.D., Miller A.L., Hamner M.B., Miller D.D., Patel J.K., Tapp A., Keefe R.S., Rosenheck R.A. Baseline use of concomitant psychotropic medications to treat schizophrenia in the CATIE trial. Psychiatr. Serv. 2006, 57(8):1094-1101.
28. Chiu H.F.K., Shum P.S., Lam C.W. Psychotropic drug prescribing to chronic schizophrenics in a Hong Kong hospital. Int. J. Soc. Psychiatry 1991, 37(3):187.
29. Chong S.A., Remington G.J., Lee N., Mahendran R. Contrasting clozapine prescribing patterns in the east and west?. Ann. Acad. Med. Singapore 2000, 29(1):75-78.
30. Chong S.A., Sachdev P., Mahendran R., Chua H.C. Neuroleptic and anticholinergic drug use in Chinese patients with schizophrenia resident in a state psychiatric hospital in Singapore. Aust. N.Z. J. Psychiatry 2000, 34(6):988-991.
31. Chong S.A., Remington G.J., Bezchlibnyk-Butler K.Z. Effect of clozapine on polypharmacy. Psychiatr. Serv. 2000, 51(2):250-252. Feb.
32. Chong M.Y., Tan C.H., Fujii S., Yang S.Y., Ungvari G.S., Si T., Chung E.K., Sim K., Tsang H.Y., Shinfuku N. Antipsychotic drug prescription for schizophrenia in East Asia: rationale for change. Psychiatry Clin. Neurosci. 2004, 58(1):61-67.
33. Chong S.A., Ravichandran N., Poon L.Y., Soo K.L., Verma S. Reducing polypharmacy through the introduction of a treatment algorithm: use of a treatment algorithm on the impact on polypharmacy. Ann. Acad. Med. Singapore 2006, 35(7):457-460.
34. Clark A., Holden N. The persistence of prescribing habits: a survey and follow-up of prescribing to chronic hospital in-patients. Br. J. Psychiatry 1987, 150:88.
35. Clark R.E., Bartels S.J., Mellman T.A., Peacock W.J. Recent trends in antipsychotic combination therapy of schizophrenia and schizoaffective disorder: implications for state mental health policy. Schizophr. Bull. 2002, 28(1):75-84.
36. Connolly A., Taylor D. Ethnicity and quality of antipsychotic prescribing among in-patients in south London. Br. J. Psychiatry 2008, 193(2):161-162.
37. Connolly A., Rogers P., Taylor D. Antipsychotic prescribing quality and ethnicity: a study of hospitalized patients in south east London. J. Psychopharmacol. 2007, 21(2):191-197.
38. Correll C.U., Rummel-Kluge C., Corves C., Kane J.M., Leucht S. Antipsychotic combinations vs monotherapy in schizophrenia: a meta-analysis of randomized controlled trials. Schizophr. Bull. 2009, 35(2):443-457.
39. Correll C.U., Shaikh L., Gallego J.A., Nachbar J., Olshanskiy V., Kishimoto T., Kane J.M. Antipsychotic polypharmacy: a survey study of prescriber attitudes, knowledge and behavior. Schizophr. Res. 2011, 131(1-3):58-62.
40. Covell N.H., Jackson C.T., Evans A.C., Essock S.M. Antipsychotic prescribing practices in Connecticut's public mental health system: rates of changing medications and prescribing styles. Schizophr. Bull. 2002, 28(1):17-29.
41. De las Cuevas C., Sanz E.J., de la Fuente J.A., Cueto M. Polypharmacy in psychiatric patients as an alternative to limited mental health resources. Actas Esp. Psiquiatr. 2005, 33(2):81-86.
42. Divac N., Jasovic-Gasic M., Samardzic R., Lackovic M., Prostran M. Antipsychotic polypharmacy at the University Psychiatric Hospital in Serbia. Pharmacoepidemiol. Drug Saf. 2007, 16(11):1250-1251.
43. Edlinger M., Hausmann A., Kemmler G., Kurz M., Kurzthaler I., Walch T., Walpoth M., Fleischhacker W.W. Trends in the pharmacological treatment of patients with schizophrenia over a 12 year observation period. Schizophr. Res. 2005, 77(1):25-34.
44. Edwards S., Kumar V. A survey of prescribing of psychotropic drugs in a Birmingham psychiatric hospital. Br. J. Psychiatry 1984, 145:502-507.
45. Elie D., Poirier M., Chianetta J., Durand M., Gregoire C., Grignon S. Cognitive effects of antipsychotic dosage and polypharmacy: a study with the BACS in patients with schizophrenia and schizoaffective disorder. J. Psychopharmacol. 2010, 24(7):1037-1044. PubMed PMID:19164494 (Jul).
46. Ereshefsky L. Pharmacologic and pharmacokinetic considerations in choosing an antipsychotic 1999, 20-30. Physicians Postgraduate Press.
47. Essock S.M., Schooler N.R., Stroup T.S., McEvoy J.P., Rojas I., Jackson C., Covell N.H. Effectiveness of switching from antipsychotic polypharmacy to monotherapy. Am. J. Psychiatry 2011, 168(7):702-708.
48. Faries D., Ascher-Svanum H., Zhu B., Correll C., Kane J. Antipsychotic monotherapy and polypharmacy in the naturalistic treatment of schizophrenia with atypical antipsychotics. BMC Psychiatry 2005, 5:26.
49. Florez Menendez G., Blanco Ramos M., Gomez-Reino Rodriguez I., Gayoso Diz P., Bobes Garcia J. Polypharmacy in the antipsychotic prescribing in practices psychiatric out-patient clinic. Actas Esp. Psiquiatr. 2004, 32(6):333-339.
50. Fombonne E., Mousson F., Dassonville B., Bost P.S., Jaeger M., Roques N., Swain G. A study of prescriptions for psychotropic drugs at a French psychiatric hospital. Rev. Epidemiol. Sante Publique 1989, 37(1):29-36.
51. Fourrier A., Gasquet I., Allicar M.P., Bouhassira M., Lepine J.P., Begaud B. Patterns of neuroleptic drug prescription: a national cross-sectional survey of a random sample of French psychiatrists. Br. J. Clin. Pharmacol. 2000, 49(1):80-86.
52. Frangou S., Lewis M. Atypical antipsychotics in ordinary clinical practice: a pharmaco-epidemiologic survey in a south London service. Eur. Psychiatry 2000, 15(3):220-226.
53. Gallego, J.A., Nielsen, J., DeHert, M., Kane, J.M., Correll, C.U., in press. Safety and tolerability of antipsychotic polypharmacy. Expert Review on Drug Safety.
54. Galletly C.A., Tsourtos G. Antipsychotic drug doses and adjunctive drugs in the outpatient treatment of schizophrenia. Ann. Clin. Psychiatry 1997, 9(2):77-80.
55. Ganesan S., Taylor R., Rabheru K., Forbes I., Dumontet J., Procyshyn R.M. Antipsychotic polypharmacy does not increase the risk for side effects. Schizophr. Res. 2008, 98(1-3):323-324.
56. Ganguly R., Kotzan J.A., Miller L.S., Kennedy K., Martin B.C. Prevalence, trends, and factors associated with antipsychotic polypharmacy among Medicaid-eligible schizophrenia patients, 1998-2000. J. Clin. Psychiatry 2004, 65(10):1377-1388.
57. Gilmer T.P., Dolder C.R., Folsom D.P., Mastin W., Jeste D.V. Antipsychotic polypharmacy trends among Medicaid beneficiaries with schizophrenia in San Diego County, 1999-2004. Psychiatr. Serv. 2007, 58(7):1007-1010.
58. Grohmann R., Engel R.R., Geissler K.H., Ruther E. Psychotropic drug use in psychiatric inpatients: recent trends and changes over time-data from the AMSP study. Pharmacopsychiatry 2004, 37(Suppl. 1):S27-S38.
59. Hamann J., Ruppert A., Auby P., Pugner K., Kissling W. Antipsychotic prescribing patterns in Germany: a retrospective analysis using a large outpatient prescription database. Int. Clin. Psychopharmacol. 2003, 18(4):237-242.
60. Hanssens L., De Hert M., Wampers M., Reginster J.Y., Peuskens J. Pharmacological treatment of ambulatory schizophrenic patients in Belgium. Clin. Pract. Epidemol. Ment. Health 2006, 2:11.
61. Harrington M., Lelliott P., Paton C., Okocha C., Duffett R., Sensky T. The results of a multi-centre audit of the prescribing of antipsychotic drugs for in-patients in the UK. Psychiatr. Bull. 2002, 26(11):414.
62. Heresco-Levy U., Greenberg D., Wittman L., Dasberg H., Lerer B. Prescribing patterns of neuroactive drugs in 98 schizophrenic patients. Isr. J. Psychiatry Relat. Sci. 1989, 26(3):157-163.
63. Hida H., Faber M., Alberto-Gondouin M., Jalaguier E. Analyse des prescriptions de psychotropes dans un Centre Hospitalier Psychiatrique = a survey of psychotropic drugs prescribing in a psychiatric hospital. Therapie 1997, 52(6):573-578.
64. Holloway F. Prescribing for the long-term mentally ill. A study of treatment practices. Br. J. Psychiatry 1988, 152(4):511.
65. Holt R.J., Gaskins J.D. Neuroleptic drug use in a family-practice center. Am. J. Hosp. Pharm. 1981, 38(11):1716-1719.
66. Hong I.S., Bishop J.R. Anticholinergic use in children and adolescents after initiation of antipsychotic therapy. Ann. Pharmacother. 2010, 44(7-8):1171-1180.
67. Hori H., Noguchi H., Hashimoto R., Nakabayashi T., Omori M., Takahashi S., Tsukue R., Anami K., Hirabayashi N., Harada S., Saitoh O., Iwase M., Kajimoto O., Takeda M., Okabe S., Kunugi H. Antipsychotic medication and cognitive function in schizophrenia. Schizophr. Res. 2006, 86(1-3):138-146.
68. Humberstone V., Wheeler A., Lambert T. An audit of outpatient antipsychotic usage in the three health sectors of Auckland, New Zealand. Aust. N.Z. J. Psychiatry 2004, 38(4):240-245.
69. Hung G.B., Cheung H.K. Predictors of high-dose antipsychotic prescription in psychiatric patients in Hong Kong. Hong Kong Med. J. 2008, 14(1):35-39.
70. Ito H., Koyama A., Higuchi T. Polypharmacy and excessive dosing: psychiatrists' perceptions of antipsychotic drug prescription. Br. J. Psychiatry 2005, 187:243-247.
71. Jaffe A.B., Levine J. Antipsychotic medication coprescribing in a large state hospital system. Pharmacoepidemiol. Drug Saf. 2003, 12(1):41-48.
72. Janssen B., Weinmann S., Berger M., Gaebel W. Validation of polypharmacy process measures in inpatient schizophrenia care. Schizophr. Bull. 2004, 30(4):1023-1033.
73. Jerrell J.M., McIntyre R.S. Adverse events in children and adolescents treated with antipsychotic medications. Hum. Psychopharmacol. 2008, 23(4):283-290.
74. Johnson D.A., Wright N.F. Drug prescribing for schizophrenic out-patients on depot injections. Repeat surveys over 18 years. Br. J. Psychiatry 1990, 156:827-834.
75. Jones P.B., Barnes T.R., Davies L., Dunn G., Lloyd H., Hayhurst K.P., Murray R.M., Markwick A., Lewis S.W. Randomized controlled trial of the effect on quality of life of second- vs first-generation antipsychotic drugs in schizophrenia: Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS 1). Arch. Gen. Psychiatry 2006, 63(10):1079-1087.
76. Joukamaa M., Heliovaara M., Knekt P., Aromaa A., Raitasalo R., Lehtinen V. Schizophrenia, neuroleptic medication and mortality. Br. J. Psychiatry 2006, 188:122-127.
77. Keks N.A., Altson K., Hope J., Krapivensky N., Culhane C., Tanaghow A., Doherty P., Bootle A. Use of antipsychosis and adjunctive medications by an inner urban community psychiatric service. Aust. N.Z. J. Psychiatry 1999, 33(6):896-901.
78. Kiivet R.A., Llerena A., Dahl M.L., Rootslane L., Sanchez Vega J., Eklundh T., Sjoqvist F. Patterns of drug treatment of schizophrenic patients in Estonia, Spain and Sweden. Br. J. Clin. Pharmacol. 1995, 40(5):467-476.
79. Kogut S.J., Yam F., Dufresne R. Prescribing of antipsychotic medication in a medicaid population: use of polytherapy and off-label dosages. J. Manag. Care Pharm. 2005, 11(1):17-24.
80. Kreyenbuhl J., Valenstein M., McCarthy J.F., Ganoczy D., Blow F.C. Long-term combination antipsychotic treatment in VA patients with schizophrenia. Schizophr. Res. 2006, 84(1):90-99.
81. Kreyenbuhl J., Marcus S.C., West J.C., Wilk J., Olfson M. Adding or switching antipsychotic medications in treatment-refractory schizophrenia. Psychiatr. Serv. 2007, 58(7):983-990.
82. Kreyenbuhl J.A., Valenstein M., McCarthy J.F., Ganoczy D., Blow F.C. Long-term antipsychotic polypharmacy in the VA health system: patient characteristics and treatment patterns. Psychiatr. Serv. 2007, 58(4):489-495.
83. Lakey S.L., Gray S.L., Sales A.E., Sullivan J., Hedrick S.C. Psychotropic use in community residential care facilities: a prospective cohort study. Am. J. Geriatr. Pharmacother. 2006, 4(3):227-235.
84. Lass J., Mannik A., Bell J.S. Pharmacotherapy of first episode psychosis in Estonia: comparison with national and international treatment guidelines. J. Clin. Pharm. Ther. 2008, 33(2):165-173.
85. Leblanc G., Cormier H.J., Vaillancourt S., Gagne M.A., Gingras C. Who are the patients treated in an outpatient clinic with high dosage neuroleptics?. Can. J. Psychiatry 1990, 35(1):12-24.
86. Lee B., Walker V. Polypharmacy as the initial second-generation antipsychotic treatment. Psychiatr. Serv. 2008, 59(7):717.
87. Lelliott P., Paton C., Harrington M., Konsolaki M., Sensky T., Okocha C. The influence of patient variables on polypharmacy and combined high dose of antipsychotic drugs prescribed for in-patients 2002, 411-414. RCP.
88. Leppig M., Bosch B., Naber D., Hippius H. Clozapine in the treatment of 121 out-patients. Psychopharmacology 1989, 99:77-79.
89. Lerma-Carrillo I., de Pablo Bruhlmann S., del Pozo M.L., Pascual-Pinazo F., Molina J.D., Baca-Garcia E. Antipsychotic polypharmacy in patients with schizophrenia in a brief hospitalization unit. Clin. Neuropharmacol. 2008, 31(6):319-332.
90. Leslie D.L., Rosenheck R.A. Use of pharmacy data to assess quality of pharmacotherapy for schizophrenia in a national health care system: individual and facility predictors. Med. Care 2001, 39(9):923-933.
91. Leucht S., Wahlbeck K., Hamann J., Kissling W. New generation antipsychotics versus low-potency conventional antipsychotics: a systematic review and meta-analysis. Lancet 2003, 361(9369):1581-1589.
92. Leucht S., Corves C., Arbter D., Engel R.R., Li C., Davis J.M. Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis. Lancet 2009, 373(9657):31-41.
93. Lieberman J.A., Stroup T.S., McEvoy J.P., Swartz M.S., Rosenheck R.A., Perkins D.O., Keefe R.S., Davis S.M., Davis C.E., Lebowitz B.D., Severe J., Hsiao J.K. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N. Engl. J. Med. 2005, 353(12):1209-1223.
94. Lima A.R., Soares-Weiser K., Bacaltchuk J., Barnes T.R. Benzodiazepines for neuroleptic-induced acute akathisia. Cochrane Database Syst. Rev. 2002, (1). CD001950.
95. Linden M., Scheel T., Xaver Eich F. Dosage finding and outcome in the treatment of schizophrenic inpatients with amisulpride, results of a drug utilization observation study. Hum. Psychopharmacol. 2004, 19(2):111-119.
96. Linjakumpu T., Hartikainen S., Klaukka T., Koponen H., Kivela S.L., Isoaho R. Psychotropics among the home-dwelling elderly-increasing trends. Int. J. Geriatr. Psychiatry 2002, 17(9):874-883.
97. Lipsey M.W., Wilson D.B. Practical Meta Analysis. Applied Social Research Methods Series 2001, vol. 49. Sage, Thousand Oaks, CA.
98. Loosbrock D.L., Zhao Z., Johnstone B.M., Morris L.S. Antipsychotic medication use patterns and associated costs of care for individuals with schizophrenia. J. Ment. Health Policy Econ. 2003, 6(2):67-75.
99. Magliano L., Fiorillo A., Guarneri M., Marasco C., De Rosa C., Malangone C., Maj M., National Mental Health Project Working G. Prescription of psychotropic drugs to patients with schizophrenia: an Italian national survey. Eur. J. Clin. Pharmacol. 2004, 60(7):513-522.
100. Mason A.S., Nerviano V., DeBurger R.A. Patterns of antipsychotic drug use in four southeastern state hospitals. Dis. Nerv. Syst. 1977, 38(7):541-545.
101. McCue R.E., Waheed R., Urcuyo L. Polypharmacy in patients with schizophrenia. J. Clin. Psychiatry 2003, 64(9):984-989.
102. McGrath A.M., Jackson G.A. Survey of neuroleptic prescribing in residents of nursing homes in Glasgow. BMJ 1996, 312(7031):611-612.
103. McIntyre R.S., Jerrell J.M. Metabolic and cardiovascular adverse events associated with antipsychotic treatment in children and adolescents. Arch. Pediatr. Adolesc. Med. 2008, 162(10):929-935.
104. Megna J.L., Kunwar A.R., Mahlotra K., Sauro M.D., Devitt P.J., Rashid A. A study of polypharmacy with second generation antipsychotics in patients with severe and persistent mental illness. J. Psychiatr. Pract. 2007, 13(2):129-137.
105. Messer T., Tiltscher C., Schmauss M. Polypharmacy in the treatment of schizophrenia. Fortschr. Neurol. Psychiatr. 2006, 74(7):377-391.
106. Michel K., Kolakowska T. A survey of prescribing psychotropic drugs in two psychiatric hospitals. Br. J. Psychiatry 1981, 138:217-221.
107. Molina J.D., Lerma-Carrillo I., Leonor M., Pascual F., Blasco-Fontecilla H., Gonzalez-Parra S., Lopez-Munoz F., Alamo C. Combined treatment with amisulpride in patients with schizophrenia discharged from a short-term hospitalization unit: a 1-year retrospective study. Clin. Neuropharmacol. 2009, 32(1):10-15.
108. Millier A., Sarlon E., Azorin J.M., Boyer L., Aballea S., Auquier P., Toumi M. Relapse according to antipsychotic treatment in schizophrenic patients: a propensity-adjusted analysis. BMC Psychiatry 2011, 11:24.
109. Morgan R., Gopalaswamy A.K. Psychotropic drugs: another survey of prescribing patterns. Br. J. Psychiatry 1984, 144:298-302.
110. Muijen M., Silverstone T. A comparative hospital survey of psychotropic drug prescribing. Br. J. Psychiatry 1987, 150:501-504.
111. Muscettola G., Casiello M., Bolline P., Sebastiani G., Pampallona S., Tognoni G. Pattern of therapeutic intervention and role of psychiatric settings: a survey in two regions of Italy. Acta Psychiatr. Scand. 1987, 75(1):55-61.
112. Morrato E.H., Dodd S., Oderda G., Haxby D.G., Allen R., Valuck R.J. Prevalence, utilization patterns, and predictors of antipsychotic polypharmacy: experience in a multistate Medicaid population, 1998-2003. Clin. Ther. 2007, 29(1):183-195.
113. Naber D., Holzbach R., Perro C., Hippius H. Clinical management of clozapine patients in relation to efficacy and side-effects. Br. J. Psychiatry 1992, (Suppl. (17)):54-59.
114. Pandurangi A.K., Dalkilic A. Polypharmacy with second-generation antipsychotics: a review of evidence. J. Psychiatr. Pract. 2008, 14(6):345-367.
115. Paton C., Lelliott P., Harrington M., Okocha C., Sensky T., Duffett R. Patterns of antipsychotic and anticholinergic prescribing for hospital inpatients. J. Psychopharmacol. 2003, 17(2):223-229.
116. 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(2):44-49.
117. Phillips M.R., Lu S.H., Wang R.W. Economic reforms and the acute inpatient care of patients with schizophrenia: the Chinese experience. Am. J. Psychiatry 1997, 154(9):1228-1234.
118. Povlsen U., Norrng U., Fog R., Gerlach J. Tolerability and therapeutic effect of clozapine. Acta Psychiatr. Scand. 1985, 71(2):176-185.
119. Prien R.F., Caffey E.M. Guidelines for antipsychotic drug use. Med. Times 1976, 104(5):87-103.
120. Procyshyn R.M., Thompson B. Patterns of antipsychotic utilization in a tertiary care psychiatric institution. Pharmacopsychiatry 2004, 37(1):12-17.
121. Procyshyn R.M., Kennedy N.B., Tse G., Thompson B. Antipsychotic polypharmacy: a survey of discharge prescriptions from a tertiary care psychiatric institution. Can. J. Psychiatry 2001, 46(4):334-339.
122. Renkel S., Rasmussen K. Antipsychotic medication and length of stay at a psychiatric maximum-security unit in Norway (1987-2000). Nord. J. Psychiatry 2006, 60(2):132-136.
123. Rittmannsberger H., Meise U., Schauflinger K., Horvath E., Donat H., Hinterhuber H. Polypharmacy in psychiatric treatment. Patterns of psychotropic drug use in Austrian psychiatric clinics. Eur. Psychiatry 1999, 14(1):33-40.
124. Rosenheck R., Leslie D., Sernyak M. From clinical trials to real-world practice: use of atypical antipsychotic medication nationally in the Department of Veterans Affairs. Med. Care 2001, 39(3):302-308.
125. Rosholm J.U., Hallas J., Gram L.F. Concurrent use of more than one major psychotropic drug (polypsychopharmacy) in out-patients-a prescription database study. Br. J. Clin. Pharmacol. 1994, 37(6):533-538.
126. Rupnow M.F., Greenspan A., Gharabawi G.M., Kosik-Gonzalez C., Zhu Y., Stahl S.M. Incidence and costs of polypharmacy: data from a randomized, double-blind, placebo-controlled study of risperidone and quetiapine in patients with schizophrenia or schizoaffective disorder. Curr. Med. Res. Opin. 2007, 23(11):2815-2822.
127. Schmidt L.G., Siemetzki H. A differential effect profile of neuroleptic therapy of acute schizophrenic patients? Results of a clinico-naturalistic study. Nervenarzt 1988, 59(12):721-726.
128. Schorr S.G., Loonen A.J., Brouwers J.R., Taxis K. A cross-sectional study of prescribing patterns in chronic psychiatric patients living in sheltered housing facilities. Int. J. Clin. Pharmacol. Ther. 2008, 46(3):146-150.
129. Schroeder N.H., Caffey E.M., Lorei T.W. Antipsychotic drug use: physician prescribing practices in relation to current recommendations. Dis. Nerv. Syst. 1977, 38(2):114-116.
130. Schumacher J.E., Makela E.H., Griffin H.R. Multiple antipsychotic medication prescribing patterns. Ann. Pharmacother. 2003, 37(7-8):951-955.
131. Schüssler G., Müller-Oerlinghausen B. Polypharmacy in psychiatric practice. Compr. Psychiatry 1984, 25(6):566-574.
132. Segal S.P., Cohen D., Marder S.R. Neuroleptic medication and prescription practices with sheltered-care residents: a 12-year perspective. Am. J. Public Health 1992, 82(6):846-852.
133. Shajahan P., Macrae A., Bashir M., Taylor M. Who responds to aripiprazole in clinical practice? An observational study of combination versus monotherapy. J. Psychopharmacol. 2008, 22(7):778-783.
134. Sheppard C., Beyel V., Fracchia J., Merlis S. Polypharmacy in psychiatry: a multi-state comparison of psychotropic drug combinations. Dis. Nerv. Syst. 1974, 35(4):183-189.
135. Siegel S., Castellan N. Nonparametric Statistics for the Behavioral Sciences 1988, McGraw-Hill, New York.
136. Simon A.E., Peter M., Hess L., Valterio C. Antipsychotic use in patients with schizophrenia treated in private psychiatry. Swiss Med. Wkly. 2005, 135(7-8):109-115.
137. Sim K., Su A., Fujii S., Yang S.Y., Chong M.Y., Ungvari G.S., Si T., Chung E.K., Tsang H.Y., Chan Y.H., Heckers S., Shinfuku N., Tan C.H. Antipsychotic polypharmacy in patients with schizophrenia: a multicentre comparative study in East Asia. Br. J. Clin. Pharmacol. 2004, 58(2):178-183.
138. Stahl S.M. Antipsychotic polypharmacy, part 1: therapeutic option or dirty little secret?. J. Clin. Psychiatry 1999, 60(7):425-426.
139. Stahl S.M. Antipsychotic polypharmacy, part 2: tips on use and misuse. J. Clin. Psychiatry 1999, 60(8):506-507.
140. Stahl S.M., Grady M.M. High-cost use of second-generation antipsychotics under California's Medicaid program. Psychiatr. Serv. 2006, 57(1):127-129.
141. StataCorp Stata Statistical Software: Release 11 2009, StataCorp LP, College Station, TX.
142. Stroup T.S., Lieberman J.A., McEvoy J.P., Davis S.M., Swartz M.S., Keefe R.S., Miller A.L., Rosenheck R.A., Hsiao J.K. Results of phase 3 of the CATIE schizophrenia trial. Schizophr. Res. 2009, 107(1):1-12.
143. Suzuki T., Uchida H., Tanaka K.F., Nomura K., Takano H., Tanabe A., Watanabe K., Yagi G., Kashima H. Revising polypharmacy to a single antipsychotic regimen for patients with chronic schizophrenia. Int. J. Neuropsychopharmacol. 2004, 7(2):133-142.
144. Suzuki T., Uchida H., Watanabe K., Yagi G., Kashima H. A clinical case series of switching from antipsychotic polypharmacy to monotherapy with a second-generation agent on patients with chronic schizophrenia. Prog. Neuropsychopharmacol. Biol. Psychiatry 2004, 28(2):361-369.
145. Soni S.D., Sampath G., Shah A., Krska J. Rationalizing neuroleptic polypharmacy in chronic schizophrenics: effects of changing to a single depot preparation. Acta Psychiatr. Scand. 1992, 85(5):354-359.
146. Tapp A., Wood A.E., Secrest L., Erdmann J., Cubberley L., Kilzieh N. Combination antipsychotic therapy in clinical practice. Psychiatr. Serv. 2003, 54(1):55-59.
147. Taylor D., Holmes R., Hilton T., Paton C. Evaluating and improving the quality of risperidone prescribing. Psychiatr. Bull. 1997, 21(11):680.
148. Taylor D., Drummond S., Pendlebury J. Olanzapine in practice. Psychiatr. Bull. 1998, 22(9):552.
149. Taylor D., Mace S., Mir S., Kerwin R. A prescription survey of the use of atypical antipsychotics for hospital inpatients in the United Kingdom. Int. J. Psychiatry Clin. Pract. 2000, 4(1):41-46.
150. Taylor D.M., Young C., Paton C. Prior antipsychotic prescribing in patients currently receiving clozapine: a case note review. J. Clin. Psychiatry 2003, 64(1):30-34.
151. Taylor D., Young C., Esop R., Paton C., Walwyn R. Testing for diabetes in hospitalised patients prescribed antipsychotic drugs. Br. J. Psychiatry 2004, 185:152-156.
152. Taylor M., Shajahan P., Lawrie S.M. Comparing the use and discontinuation of antipsychotics in clinical practice: an observational study. J. Clin. Psychiatry 2008, 69(2):240-245.
153. Tempier R.P., Pawliuk N.H. Conventional, atypical, and combination antipsychotic prescriptions: a 2-year comparison. J. Clin. Psychiatry 2003, 64(6):673-679.
154. Tibaldi G., Munizza C., Bollini P., Pirfo E., Punzo F., Gramaglia F. Utilization of neuroleptic drugs in Italian mental health services: a survey in Piedmont. Psychiatr. Serv. 1997, 48(2):213-217.
155. Tirupati S., Chua L.E. Obesity and metabolic syndrome in a psychiatric rehabilitation service. Aust. N.Z. J. Psychiatry 2007, 41(7):606-610.
156. Tognoni G. Pharmacoepidemiology of psychotropic drugs in patients with severe mental disorders in Italy. Eur. J. Clin. Pharmacol. 1999, 55(9):685-690.
157. Tomasi R., de Girolamo G., Santone G., Picardi A., Micciolo R., Semisa D., Fava S., Group P. The prescription of psychotropic drugs in psychiatric residential facilities: a national survey in Italy. Acta Psychiatr. Scand. 2006, 113(3):212-223.
158. Tranulis C., Skalli L., Lalonde P., Nicole L., Stip E. Benefits and risks of antipsychotic polypharmacy: an evidence-based review of the literature. Drug Saf. 2008, 31(1):7-20.
159. Tu J.B. A survey of psychotropic medication in mental retardation facilities. J. Clin. Psychiatry 1979, 40(3):125-128.
160. Ungvari G.S., Chung Y.G., Chee Y.K., Fung-Shing N., Kwong T.W., Chiu H.F. The pharmacological treatment of schizophrenia in Chinese patients: a comparison of prescription patterns between 1996 and 1999. Br. J. Clin. Pharmacol. 2002, 54(4):437-444.
161. Valuck R.J., Morrato E.H., Dodd S., Oderda G., Haxby D.G., Allen R., Medicaid Pharmacotherapy Research C. How expensive is antipsychotic polypharmacy? Experience from five US state Medicaid programs. Curr. Med. Res. Opin. 2007, 23(10):2567-2576.
162. Vinogradov S., Fisher M., Warm H., Holland C., Kirshner M.A., Pollock B.G. The cognitive cost of anticholinergic burden: decreased response to cognitive training in schizophrenia. Am. J. Psychiatry 2009, 166(9):1055-1062.
163. Volavka J., Citrome L. Heterogeneity of violence in schizophrenia and implications for long-term treatment. Int. J. Clin. Pract. 2008, 62(8):1237-1245.
164. Waddington J.L., Youssef H.A., Kinsella A. Mortality in schizophrenia. Antipsychotic polypharmacy and absence of adjunctive anticholinergics over the course of a 10-year prospective study. Br. J. Psychiatry 1998, 173:325-329.
165. Wang P.S., West J.C., Tanielian T., Pincus H.A. Recent patterns and predictors of antipsychotic medication regimens used to treat schizophrenia and other psychotic disorders. Schizophr. Bull. 2000, 26(2):451-457.
166. Warner J., Slade R., Barnes T. Change in neuroleptic prescribing practice. Psychiatr. Bull. 1995, 19(4):237.
167. Weinmann S., Janssen B., Gaebel W. Switching antipsychotics in inpatient schizophrenia care: predictors and outcomes. J. Clin. Psychiatry 2004, 65(8):1099-1105.
168. Weissman E.M. Antipsychotic prescribing practices in the Veterans Healthcare Administration-New York metropolitan region. Schizophr. Bull. 2002, 28(1):31-42.
169. West J.C., Wilk J.E., Olfson M., Rae D.S., Marcus S., Narrow W.E., Pincus H.A., Regier D.A. Patterns and quality of treatment for patients with schizophrenia in routine psychiatric practice. Psychiatr. Serv. 2005, 56(3):283-291.
170. Wheeler A., Humberstone V., Robinson G. Trends in antipsychotic prescribing in schizophrenia in Auckland. Australas. Psychiatry 2006, 14(2):169-174.
171. Williams C.L., Johnstone B.M., Kesterson J.G., Javor K.A., Schmetzer A.D. Evaluation of antipsychotic and concomitant medication use patterns in patients with schizophrenia. Med. Care 1999, 37(4 Suppl. Lilly):AS81-AS86.
172. Xiang Y.T., Weng Y.Z., Leung C.M., Tang W.K., Ungvari G.S. Clinical and social determinants of antipsychotic polypharmacy for Chinese patients with schizophrenia. Pharmacopsychiatry 2007, 40(2):47-52.
173. Xiang Y.T., Weng Y.Z., Leung C.M., Tang W.K., Ungvari G.S. Clinical and social correlates with the use of depot antipsychotic drugs in outpatients with schizophrenia in China. Int. J. Clin. Pharmacol. Ther. 2008, 46(5):245-251.
174. Yip K., Ungvari G., Cheung H., Ng F., Lau S. A survey of antipsychotic treatment for schizophrenia in Hong Kong. Chin. Med. J. 1997, 110(10):792.
175. Yosselson-Superstine S., Sternik D., Liebenzon D. Prescribing patterns in psychiatric hospitals in Israel. Acta Psychiatr. Scand. 1979, 60(5):477-482.
176. Zarate C.A., Quiroz J.A. Combination treatment in bipolar disorder: a review of controlled trials. Bipolar Disord. 2003, 5(3):217-225.