Department of Psychiatry and Psychotherapy, Georg-August-University, Goettingen, Germany. cwolff @gwdg.de
Pharmacopsychiatry. 2010 Jun;43(4):122-9. doi: 10.1055/s-0030-1249097. Epub 2010 Mar 22.
Although the international guidelines for the treatment of schizophrenia recommend antipsychotic monotherapy as the treatment of choice, many schizophrenia patients receive two or more antipsychotics in clinical practice, while co-treatment with antidepressants, mood stabilizers and benzodiazepines is also common.
The aim of the present review is to summarize the results of the randomized controlled trials of combination therapy versus monotherapy in schizophrenia and to discuss possible implications of these results.
Altogether, recommendations are based upon theoretical assumptions rather than upon evidence-based knowledge regarding the combination of different antipsychotics or antipsychotics with other psychotropic agents in schizophrenia treatment, since the available studies reveal conflicting results. The augmentation with antidepressants for the treatment of persisting negative symptoms and with mood stabilizers in patients with additional affective symptoms seems to be a successful strategy.
Further randomized controlled trials are warranted to provide substantial evidence and to suggest combination strategies for treatment-resistant schizophrenia.
尽管国际精神分裂症治疗指南推荐抗精神病药物单药治疗作为首选，但在临床实践中，许多精神分裂症患者接受两种或多种抗精神病药物治疗，同时联合使用抗抑郁药、心境稳定剂和苯二氮䓬类药物也很常见。
本综述的目的是总结精神分裂症联合治疗与单药治疗的随机对照试验结果，并讨论这些结果的可能意义。
总的来说，这些建议是基于理论假设，而不是基于关于不同抗精神病药物联合使用或抗精神病药物与精神分裂症治疗中其他精神药物联合使用的循证知识，因为现有研究结果存在矛盾。抗抑郁药联合治疗持续性阴性症状和心境稳定剂联合治疗伴有附加情感症状的患者似乎是一种成功的策略。
需要进一步的随机对照试验提供实质性证据，并提出治疗抵抗性精神分裂症的联合治疗策略。
