In search of appropiate antipsychotic polypharmacy in schizophrenia spectrum disorders

Marc Lochmann van Bennekom • Boek • paperback

• Samenvatting
  Free download at https://doi.org/10.54195/9789465150512
  
  Antipsychotic polypharmacy (APP) in clinical practice to date has consisted of combining two antipsychotic agents that primarily target the striatal postsynaptic D2 receptor in a form of same-class polypharmacy. The evidence for the efficacy and safety of APP from the systematic reviews and meta-analyses that we reviewed is weak and inconclusive. We have shown that personalized, guideline-based instructions can reduce APP to some extent. We have found that cross-titration switching of antipsychotics poses a risk for the emergence of potentially inappropriate persistent APP if a patient improves during the switch and the switch is therefore not completed. This is sometimes referred to as the cross-titration trap. We have also found that there is a subgroup of difficult-to-treat psychotic patients who may benefit from APP. This subgroup consists of more severely psychotic patients with predominantly positive symptoms. However, it remains unclear which combinations of agents are most effective and what the mechanism of action is, which warrants further research. Given the efficacy of clozapine on symptom reduction in patients with treatment-resistant psychotic disorders, it is important that treatment with clozapine be tried first before applying APP. These conclusions may give APP a clearer position in future guidelines for the treatment of psychotic disorders, especially considering the results in areas other than mere symptom reduction.
• Productinformatie
  Binding : Paperback
  Distributievorm : Boek (print, druk)
  Formaat : 170mm x 240mm
  Aantal pagina's : 205
  Uitgeverij : Radboud University Press
  ISBN : 9789465150512
  Datum publicatie : 04-2025
  
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