Polypharmacy Is Common in Psychiatry, But Is More Better?

A study of antidepressant and antipsychotic treatment effects showed there is an emphasis on “polypharmacy” in clinical practice, without much evidence of benefit and an increase in adverse effects. Swiss investigators reported these findings at the 23rd European College of Neuropsychopharmacology Congress.

“In our study, we found no advantages for ‘complex’ treatment approaches over conventional monotherapeutic approaches,” said senior investigator Hans H. Stassen, PhD, of University Hospital of Psychiatry in Zurich, Switzerland, in an interview during the meeting. “There appear to be no controlled studies showing the superiority of combinations of drugs over monotherapy. We looked at this because we have observed in clinical practice that response rates are less and side effects are greater. We believe that the issue of polypharmacy in psychiatric practice deserves more scientific attention.”

Treatment with antidepressants and antipsychotics, though effective, is unspecific in a number of ways, the study authors pointed out. For instance, agents that differ greatly in their biochemical and pharmacological actions can have virtually the same efficacy, patients with initial improvement often show incomplete response, and many patients are clinically refractory to all treatments. As a strategy for overcoming this unsatisfactory situation, polypharmaceutical approaches have gained favor in recent years. Today’s “standard” treatment regimens rely on various combinations of antidepressants, antipsychotics, mood stabilizers, anxiolytics, hypnotics, analgesics, antiparkinson drugs, cardiovascular agents, and other somatic treatments, the study authors noted.

Reported by Caroline Helwick

Submitted by Anna

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