The Rationale and Effect of Antipsychotics Combination Therapy

Lee, Yanghyun

Abstract

Up to the present date, the principle of antipsychotics treatment in patients with schizophrenia is antipsychotics monotherapy. The reasons for the drug monotherapy may be associated with the fact that typical antipsychotics were assumed to have similar mechanism of action and that combination use of more than two antipsychotics would offer no benefit over that of monotherapy with the agents. However, because the newer `atypical' antipsychotics have the notable features in their diverse pharmacologic action and lower adverse event profiles, many practitioners have an interest in using the combination therapy. Some patients with schizophrenia and schizoaffective disorder have no response to atypical antipsychotics and the studies increasingly reported that the antipsychotics combinations improve the symptom profiles of psychotic patients. Thus, the antipsychotic combination therapy is an additional option in treatment-resistant psychotic patients. These combination therapies are commonly used in clinical practice, but we are in lack of the evidence of the rationale and background of this practice. Since most studies for antipsychotics combination therapy are open trial or retrospective study, we need the further prospective clinical studies with double-blind, placebo-controlled design in order to definitively determine the effectiveness of such practice.