Antipsychotic Polypharmacy (App) For The Management Of Schizophrenia
Introduction:
In rare cases of difficult to treat psychosis, we have to look at many approaches. APP, the use of two anti psychotic meds together, can be more effective than one, especially in complex cases. At Philadelphia Integrative Psychiatry, we apply this knowledge, tailoring treatments to each patient's unique needs.
Focused on reducing symptoms like anxiety and improving overall well-being, our approach balances efficacy and safety, ensuring the best care for you.
Source: NCBI Study
General Overview:
Definition: APP involves the concurrent use of two antipsychotic medications.
Usage: Frequently used, despite not being recommended by most treatment guidelines.
Reasons for APP:
Treatment Response: Primary reason is insufficient response to antipsychotic monotherapy (APM).
Symptom Management: Targets specific symptoms like negative symptoms, anxiety, cognitive dysfunction, impulsive behavior, and sleep disturbances.
Medication Management: Reduces doses of individual medications, medication costs, and extrapyramidal symptoms.
Efficacy and Safety:
Effectiveness:
Some studies indicate APP can be more effective than APM, particularly in reducing negative symptoms and total symptom burden.
Safety: APP does not significantly increase mortality; may reduce certain side effects while increasing others.
Disadvantages:
Side Effects: Increased prevalence and severity of side effects, reduced medication adherence.
Complexity: Higher risk of medication interactions and errors due to treatment complexity.
Recommendations and Considerations:
Initial Approach: Strive for antipsychotic monotherapy; consider long-acting injectables or blood concentration measurements for adherence and optimal dosing.
Clozapine Use: Underutilized; should be considered more widely, especially before switching to APP.
Combinations may be chosen to address specific comorbid symptoms like anxiety, cognitive dysfunction, or sleep disturbances.
Safety and Efficacy Considerations:
While some combinations reduce side effects, others may increase them. The choice of combination should be tailored to the individual patient’s needs and response to treatment.
Transitioning:
Many patients on APP could be safely switched back to APM, especially those responding well or showing stable conditions.
Conclusion:
Anti-psychotic Polypharmacy may be more effective than mono-therapy for some patients. However, each case should be assessed individually.Need for more research to establish optimal APP strategies and to update treatment guidelines. It's important not to rule out APP universally, as it has potential uses for certain patient groups.
Your Journey to Wellness Begins with Philadelphia Integrative Psychiatry:
To embark on your path to anxiety-free living, we invite you to explore the possibilities at Philadelphia Integrative Psychiatry. Visit our website at www.phillyintegrative.com or call 610-999-6414 to schedule a consultation. Your journey towards comprehensive and integrative care begins here, where families and healthcare providers unite for the betterment of individuals on the autism spectrum.
