Combination of two or more antipsychotic medications for psychotic disorders
Question 2: In individuals with psychotic disorders (including schizophrenia), is the use of two or more antipsychotic medications concurrently more effective and safer than the use of one antipsychotic only?
- Population: patients with psychotic disorders, including schizophrenia (partial or non-response)
- Interventions: antipsychotic combination therapy (two antipsychotics concurrently)
- Comparison: antipsychotic monotherapy
- Outcomes:
- symptoms severity
- prevention of relapses
- disability and functioning
- adverse effects of treatment
- quality of life
- all-cause mortality, including by suicide
- treatment adherence or concordance
- users' and families' satisfaction with care (including users and families involvement).
Recommendation(s)
Routinely, one antipsychotic should be prescribed at a time in individuals with psychotic disorders (including schizophrenia).
Strength of recommendation: STRONG
For individuals with psychoses (including schizophrenia) who do not respond to adequate dose and duration of more than one antipsychotic medicine (using one medicine at a time), antipsychotic combination treatment may be considered by primary health care professionals preferably under the supervision of mental health professionals with close clinical monitoring.
Strength of recommendation: STANDARD