+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

A translational research approach to poor treatment response in patients with schizophrenia: clozapine-antipsychotic polypharmacy



A translational research approach to poor treatment response in patients with schizophrenia: clozapine-antipsychotic polypharmacy



Journal of Psychiatry and Neuroscience 34(6): 433-442



Poor treatment response in patients with schizophrenia is an important clinical problem, and one possible strategy is concurrent treatment with more than one antipsychotic (polypharmacy). We analyzed the evidence base for this strategy using a translational research model focused on clozapine-antipsychotic polypharmacy (CAP). We considered 3 aspects of the existing knowledge base and translational research: the link between basic science and clinical studies of efficacy, the evidence for effectiveness in clinical research and the implications of research for the health care delivery system. Although a rationale for CAP can be developed from receptor pharmacology, there is little available preclinical research testing these concepts in animal models. Randomized clinical trials of CAP show minimal or no benefit for overall severity of symptoms. Most studies at the level of health services are limited to estimates of CAP prevalence and some suggestion of increased costs. Increasing use of antipsychotic polypharmacy in general may be a factor contributing to the under-utilization of clozapine and long delays in initiating clozapine monotherapy. Translational research models can be applied to clinical questions such as the value of CAP. Better linkage between the components of translational research may improve the appropriate use of medications such as clozapine in psychiatric practice.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 051278967

Download citation: RISBibTeXText

PMID: 19949719


Related references

Antipsychotic Polypharmacy in Clozapine Resistant Schizophrenia: A Randomized Controlled Trial of Tapering Antipsychotic Co-treatment. Mental Illness 4(1): E1, 2012

Antipsychotic prescribing pathways, polypharmacy, and clozapine use in treatment of schizophrenia. Psychiatric Services 64(6): 527-533, 2013

Use of Clozapine and Antipsychotic Polypharmacy among patients with Schizophrenia: characterizing the prescribers. Value in Health 18(3): A127-A128, 2015

Prescribing of Clozapine and Antipsychotic Polypharmacy for Schizophrenia in a Large Medicaid Program. Psychiatric Services 68(6): 579-586, 2017

Evaluation of the individual safe correction of antipsychotic agent polypharmacy in Japanese patients with chronic schizophrenia: validation of safe corrections for antipsychotic polypharmacy and the high-dose method. International Journal of Neuropsychopharmacology 18(5):, 2014

The effect of long-term antipsychotic treatment on the body weight of patients suffering from chronic schizophrenia: clozapine versus classical antipsychotic agents. International Clinical Psychopharmacology 14(4): 229-232, 1999

Premorbid behavioral and intellectual functioning in schizophrenia patients with poor response to treatment with antipsychotic drugs. Schizophrenia Research 94(1-3): 45-49, 2007

How Long to Wait for a Response to Clozapine: A Comparison of Time Course of Response to Clozapine and Conventional Antipsychotic Medication in Refractory Schizophrenia. Schizophrenia Bulletin 25(4): 709-719, 1999

How long to wait for a response to clozapine: a comparison of time course of response to clozapine and conventional antipsychotic medication in refractory schizophrenia. Schizophrenia Bulletin 25(4): 709-719, 1999

QTc interval in patients with schizophrenia receiving antipsychotic treatment as monotherapy or polypharmacy. Cns Spectrums 23(4): 278-283, 2018

Antipsychotic monotherapy and polypharmacy in the treatment of outpatients with schizophrenia in the European Schizophrenia Outpatient Health Outcomes Study. Journal of Nervous and Mental Disease 200(7): 637-643, 2012

Delayed initiation of clozapine may be related to poor response in treatment-resistant schizophrenia. International Clinical Psychopharmacology 30(5): 290-295, 2015

Antipsychotic plasma levels in the assessment of poor treatment response in schizophrenia. Acta Psychiatrica Scandinavica 137(1): 39-46, 2018

Cost of antipsychotic polypharmacy in the treatment of schizophrenia. Bmc Psychiatry 8: 19, 2008

Critical review of antipsychotic polypharmacy in the treatment of schizophrenia. International Journal of Neuropsychopharmacology 17(7): 1083-1093, 2014