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Does the admonition to use antipsychotic monotherapy acutely in schizophrenia apply to maintenance treatment? Two research groups provide more data.
Tiihonen and colleagues examined Finnish national registry data on 62,250 schizophrenia patients discharged on antipsychotic monotherapy (median follow-up, 14 years); over follow-up, 58% received combinations of antipsychotics for ≥90 days. In within-individual analyses, the risk for psychiatric rehospitalization was 7% lower with any antipsychotic combination (polypharmacy) than any monotherapy. In sensitivity analyses ignoring the first 90 days of polypharmacy (presumably representing a crossover period), the risk was 13% lower. The most effective combination was clozapine plus aripiprazole, w…