In an ideal setting, schizophrenia should be treated with a single antipsychotic agent. But in order to enhance, broaden and sustain treatment efficacy, as well as attenuate adverse effects, APP* treatment might be initiated despite lack of general support in treatment guidelines.1
In a recent publication in Frontier Psychiatry, Stephan Hjorth has summarized clinical literature related to the use of APP, with the prime focus upon pharmacological underpinnings in relation to the diverging outcome of combinations of different antipsychotic agents.1
* APP: Antipsychotic polypharmacy/drug combination treatment
“APP treatment may be useful in selected patients when switch is not desired or feasible, but is NOT to be applied for ROUTINE use. (..) Any APP regimen should be based on drugs that are complementary, beneficial from an efficacy/AE outcome perspective, and follow a clear therapeutic rationale, avoiding pharmacokinetic (PK) as well as pharmacodynamic (PD) risks ”
Hjorth, Front. Psychiatry. 2021
