A systematic review of the treatment of schizophrenia: monotherapy vs antipsychotics combination
DOI:
https://doi.org/10.25118/2763-9037.2023.v13.414Keywords:
schizophrenia, polypharmacy, prognosisAbstract
Introduction: The pharmacological treatment of schizophrenia with the association of antipsychotics is a very common practice, although there is no consolidated scientific evidence to support this practice, not even some guidance regard to the clinical treatment guidelines. Objective: To evaluate the effectiveness and risks of using the combination of antipsychotics comparing to using antipsychotics in monotherapy in the treatment of schizophrenia. Method: A literature review was carried out in search for scientific studies which compared the use of antipsychotics in monotherapy with the use of antipsychotics in association for the treatment of schizophrenia. Results: Most studies showed no differences in symptom control between the groups. However, there was a lower frequency of relapse of symptoms and a decrease in hospitalizations in patients treated with antipsychotic monotherapy. In addition, there were fewer adverse effects in patients with this therapeutic option. Adherence was lower when switching from antipsychotic combination treatment to antipsychotic monotherapy. However, the change was well tolerated and in almost all patients favorable results were observed. Conclusions: The treatment of schizophrenia and schizoaffective disorder with antipsychotic monotherapy presents a symptom control like the treatment with combination of antipsychotics. However, in monotherapy the occurrence of side effects, relapses and hospitalization is lower. Therefore, this review emphasizes that in clinical practice the pharmacological treatment of schizophrenia, as well as schizoaffective disorder, should prioritize the use of antipsychotics in monotherapy.
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