PMID- 34690115
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20211201
IS  - 1738-1088 (Print)
IS  - 2093-4327 (Electronic)
IS  - 1738-1088 (Linking)
VI  - 19
IP  - 4
DP  - 2021 Nov 30
TI  - Exploring Hidden Issues in the Use of Antipsychotic Polypharmacy in the Treatment 
      of Schizophrenia.
PG  - 600-609
LID - 10.9758/cpn.2021.19.4.600 [doi]
AB  - The mainstay of schizophrenia treatment is pharmacological therapy using various 
      antipsychotics including first- and second-generation antipsychotics which have 
      different pharmacokinetic and pharmacodynamic property leading to differential 
      presentation of adverse events (AEs) and treatment effects such as negative 
      symptoms, cognitive symptoms and cormorbid symptoms. Major treatment guidelines 
      suggest the use of antipsychotic monotherapy (APM) as a gold standard in the 
      treatment of schizophrenia. However, the effects of APM is inadequate and less 
      potent to achieve symptom remission as well as functional recovery in real 
      practice which has been consistently reported in numerous controlled clinical 
      trials, large practical trials, independent small studies and systematic reviews 
      till today. Therefore anti-psychotic polypharmacy (APP) regardless of the class 
      of antipsychotics has been also commonly utilized for many reasons in real world 
      practice. However, APP has also crucial pitfalls including increase of total 
      psychotics including antipsychotics, high-doses of antipsychotics used, poor 
      compliance, drug-drug interaction and risks for developing AEs, all of which are 
      paradoxically related to poor clinical outcomes, whereas APP has also substantial 
      advantages in reduction of re-hospitalization, severe psychopathology and 
      targeted control of concurrent symptoms. Given currently limited therapeutic 
      options, it is also important to properly utilize APP in order to maximize its 
      clinical utility and minimize its risk for better treatment outcomes for patients 
      with schizophrenia, based on risk/benefit with full understanding of 
      pharmacological and clinical issues on APP. The present paper intends to address 
      intriguing and important issues in the use of APP in real world practice.
FAU - Kim, Jung-Jin
AU  - Kim JJ
AUID- ORCID: 0000-0003-3899-5579
AD  - Department of Psychiatry, College of Medicine, The Catholic University of Korea, 
      Seoul, Korea.
FAU - Pae, Chi-Un
AU  - Pae CU
AUID- ORCID: 0000-0003-1632-4248
AD  - Department of Psychiatry, College of Medicine, The Catholic University of Korea, 
      Seoul, Korea.
AD  - Cell Death Disease Research Center, College of Medicine, The Catholic University 
      of Korea, Seoul, Korea.
FAU - Han, Changsu
AU  - Han C
AUID- ORCID: 0000-0002-4021-8907
AD  - Department of Psychiatry, Korea University College of Medicine, Seoul, Korea.
FAU - Bahk, Won-Myong
AU  - Bahk WM
AUID- ORCID: 0000-0002-0156-2510
AD  - Department of Psychiatry, College of Medicine, The Catholic University of Korea, 
      Seoul, Korea.
FAU - Lee, Soo-Jung
AU  - Lee SJ
AUID- ORCID: 0000-0002-1299-5266
AD  - Department of Psychiatry, College of Medicine, The Catholic University of Korea, 
      Seoul, Korea.
FAU - Patkar, Ashwin A
AU  - Patkar AA
AUID- ORCID: 0000-0003-0484-1301
AD  - Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 
      Chicago, IL, USA.
FAU - Masand, Prakash S
AU  - Masand PS
AUID- ORCID: 0000-0003-1973-9449
AD  - Global Medical Education, New York, NY, USA.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Korea (South)
TA  - Clin Psychopharmacol Neurosci
JT  - Clinical psychopharmacology and neuroscience : the official scientific journal of 
      the Korean College of Neuropsychopharmacology
JID - 101207332
PMC - PMC8553537
OTO - NOTNLM
OT  - Antipsychotics
OT  - Issue
OT  - Polypharmacy
OT  - Schizophrenia
COIS- Conflicts of Interest No potential conflict of interest relevant to this article 
      was reported.
EDAT- 2021/10/26 06:00
MHDA- 2021/10/26 06:01
PMCR- 2021/11/30
CRDT- 2021/10/25 06:12
PHST- 2020/12/02 00:00 [received]
PHST- 2021/01/13 00:00 [revised]
PHST- 2021/02/02 00:00 [accepted]
PHST- 2021/10/25 06:12 [entrez]
PHST- 2021/10/26 06:00 [pubmed]
PHST- 2021/10/26 06:01 [medline]
PHST- 2021/11/30 00:00 [pmc-release]
AID - cpn.2021.19.4.600 [pii]
AID - cpn-19-4-600 [pii]
AID - 10.9758/cpn.2021.19.4.600 [doi]
PST - ppublish
SO  - Clin Psychopharmacol Neurosci. 2021 Nov 30;19(4):600-609. doi: 
      10.9758/cpn.2021.19.4.600.