Antipsychotic polypharmacy: review of mechanisms, mortality and management

Summary Antipsychotic polypharmacy is an increasingly encountered clinical scenario. This review considers the reasons behind antipsychotic polypharmacy and the patterns of its use. We also consider the evidence of effectiveness of combined therapy v. monotherapy and the rationale behind the potentially beneficial combinations that are used. The potential dangers of antipsychotic polypharmacy are also discussed and the limited research regarding switching from polypharmacy to monotherapy is reviewed. Some provisional recommendations regarding antipsychotic polypharmacy are proposed.