The term polypharmacy was originally coined to refer to problems related to multiple drug consumption and excessive drug use during the treatment of a disease or disorder. In the treatment of schizophrenia, polypharmacy usually refers to the simultaneous use of 2 or more antipsychotic medications or combined (adjunct) medications such as mood stabilizers, antidepressants, anxiolytics, or hypnotics in addition to single or multiple antipsychotics. Two decades ago, antipsychotic polypharmacy was criticized as being more expensive, having unproven efficacy, and causing more side effects. However, in recent years, antipsychotic polypharmacy has become more or less acceptable in the views of clinical practitioners and academic researchers. Results from recent reviews have suggested that the common practice of antipsychotic polypharmacy lacks double-blind or high-quality evidence of efficacy, except for negative symptom reduction with aripiprazole augmentation. We reviewed some representative studies that enrolled large numbers of patients and compared antipsychotic polypharmacy and monotherapy during the past decade. The results revealed that a certain proportion of select patients can benefit from antipsychotic polypharmacy without further negative consequences. Because most of the current treatment guidelines from different countries and organizations prefer monotherapy and discourage all antipsychotic polypharmacy, guidelines regarding the use of antipsychotic polypharmacy in clinical practice should be revised. On the basis of the findings of 2 large-scale studies from Asia and Europe, we also suggest ideal rates of various maintenance treatments of schizophrenia, which are as follows: antipsychotic polypharmacy, 30%; combined mood stabilizer, 15%; combined antidepressant, 10%; combined anxiolytics, 30%; and combined hypnotic, 10%.

中文翻译：

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抗精神病药房：肮脏的小秘密还是时尚？

最初，“多药店”一词的产生是指与在疾病或病症治疗期间多次服用药物和过度使用药物有关的问题。在精神分裂症的治疗中，除单一或多种抗精神病药外，多药房通常是指同时使用两种或更多种抗精神病药或联合（辅助）药物，如情绪稳定剂，抗抑郁药，抗焦虑药或催眠药。二十年前，抗精神病药被批评为价格昂贵，功效未经证实并引起更多的副作用。然而，近年来，从临床从业者和学术研究者的观点来看，抗精神病药业已经或多或少地被接受。最新评论的结果表明，抗精神病药物多药房的常规做法缺乏双盲或高质量的疗效证据，但使用阿立哌唑增强可减轻不良症状。我们回顾了一些代表性研究，这些研究招募了大量患者，并比较了过去十年中抗精神病药和单药治疗的情况。结果表明，一定比例的特定患者可以从抗精神病药房中受益，而不会产生进一步的负面后果。由于来自不同国家和组织的当前大多数治疗指南都倾向于单药治疗，并且不鼓励使用所有抗精神病药物，因此应修订有关在临床实践中使用抗精神病药物的指南。根据来自亚洲和欧洲的2项大规模研究的发现，我们还建议了各种维持精神分裂症的治疗方法的理想比例，如下所示：抗精神病药房，30％；组合情绪稳定剂，占15％；联合抗抑郁药，10％；联合抗焦虑药，30％；并合并催眠药，占10％。