Table of Contents
ISRN Pharmacology
Volume 2014 (2014), Article ID 762127, 9 pages
http://dx.doi.org/10.1155/2014/762127
Clinical Study

Efficacy and Clinical Determinants of Antipsychotic Polypharmacy in Psychotic Patients Experiencing an Acute Relapse and Admitted to Hospital Stay: Results from a Cross-Sectional and a Subsequent Longitudinal Pilot Study

1Department of Neuroscience, Reproductive Sciences and Odontostomatology, University “Federico II” of Naples, Via Pansini 5, 80131 Naples, Italy
2Hermanas Hospitalarias, Villa San Giuseppe Hospital, 63100 Ascoli Piceno, Italy
3NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “G. Mazzini”, ASL 4, 64100 Teramo, Italy
4Department of Neurosciences and Imaging, University “G. d’Annunzio” of Chieti, 66013 Chieti, Italy
5Department of Life, Health and Environmental Sciences, University of L’Aquila, 67010 L’Aquila, Italy
6FORIPSI, 00199 Rome, Italy

Received 22 September 2013; Accepted 30 October 2013; Published 27 January 2014

Academic Editors: G. Froldi, J.-A. Mico, and K. Wada

Copyright © 2014 Felice Iasevoli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Antipsychotic polypharmacy is used in several psychiatric disorders, despite poor evidence existing to support this practice. Aim. We evaluated whether psychotic patients in acute relapse exposed to antipsychotic polypharmacy (AP + AP) showed different demographic, clinical, or psychopathological features compared to those exposed to one antipsychotic (AP) and whether AP + AP patients showed significantly higher improvement compared to AP patients after a 4-week treatment. Methods. Inpatients were subdivided into AP + AP and AP ones. In the cross-sectional step, patients were compared according to demographics, clinical variables, and scores on rating scales. In the longitudinal step, patients remained for 4 weeks under admission medications and were compared for clinical improvement. Results. AP + AP patients were more frequently diagnosed with schizophrenia and mental retardation as a comorbid illness. AP + AP patients were more frequently under first-generation antipsychotics and had worse clinical presentation. After 4 weeks of treatment, both AP + AP and AP patients improved compared to the baseline. However, AP patients scored significantly less than AP + AP patients at the Clinical Global Impression Scale at the 4-week time point but not at the baseline, indicating a treatment-specific improvement. Conclusions. Antipsychotic polypharmacy may be offered to specific types of psychotic patients. However, efficacy of this strategy is limited at best.