Declaration of interest J.M.M. reports speaking or advising fees from Acadia Pharmaceuticals, Alkermes, Forum Pharmaceuticals, Merck, Otsuka America, Inc., Sunovion Pharmaceuticals and Teva Pharmaceutical Industries. S.M.S. has served as a consultant for Acadia, BioMarin, EnVivo Pharmaceuticals, Forum Pharmaceuticals, Jazz Pharmaceuticals, Orexigen Therapeutics, Otsuka, Pamlab, Servier, Shire, Sprout, Taisho Pharmaceutical, Takeda and Trius Therapeutics; as an Advisory Board Member for BioMarin, EnVivo, Forum, Genomind, Lundbeck, Otsuka, RCT Logic and Shire; on the Speakers Bureau for Forum, Takeda, Servier and Sunovion UK; and he has received research and/or grant support from Alkermes, Clintara, Eli Lilly, Forest Laboratories, Forum, Genomind, JayMac Pharmaceuticals, Jazz, Merck, Novartis, Otsuka, Pamlab, Pfizer, Servier, Shire, Sprout, Sunovion, Sunovion UK, Takeda, Teva and Tonix.
The majority of patients respond to antipsychotic monotherapy at standard doses, but a subset of patients will require more heroic measures that include antipsychotic polypharmacy and high-dose monotherapy. Indeed, research has shown that roughly 30% of patients with psychosis are prescribed multiple antipsychotic medications. We discuss the potential benefits and challenges of these approaches and provide a rationale for why and when they should be utilised.
- © 2016 The Authors
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of U.S. Army Regional Health Command-Central, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army and Department of Defense or the U.S. Government.