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Despite the large number of psychotropic medications currently available, effective management of mental disorders continues to be a challenging task. Although monotherapy may be desirable, most patients require combinations of two or more psychotropic drugs. Polypharmacy aims to address different aspects of treatment resistance, especially insufficient response of positive and negative symptoms, cognitive disturbances, affective comorbidity, obsessive-compulsive syndromes and side-effects of antipsychotic agents. At the same time, evidence based guidelines in support of polypharmacy, and augmentative strategies are scant.
This two-volume collection is the first comprehensive, clinically oriented, reference text on polypharmacy (co-administration of more than one medication) or the use of multiple preparations to treat psychotic, cognitive, mood and anxiety disorders. This collection is divided into four parts.
Volume I contains two parts including chapters that serve as an introduction and overview of conceptual issues. Key topics include: rational polypharmacy, receptor binding targets, drug interactions, preclinical and clinical investigations in this field, dosing regimens, multiple medication use in forensic psychiatry, a naturalistic trial, adjunctive strategies, and multiple medication use for the treatment of somatic symptom disorders.
Volume II contains two parts that focus on antipsychotic polypharmacy for schizophrenia, and clinical practice in the USA, Czech Republic, Ukraine, and Italy, polypharmacy and associated phenomena, clozapine combinations and the metabolic syndrome. The authors discuss combination therapy for bipolar disorder, major depressive disorder, obsessive-compulsive syndromes in schizophrenia, and potentially inappropriate medication use among elderly patients with dementia.
Finally, each volume includes Appendix contains Annotated bibliography on polypharmacy and List of Psychotropic Medications .
List of contents
1. Multiple medication use in psychiatry: How Rational Can It Be?. - 2. Receptor binding targets for antipsychotic efficacy. - 3. Drug interactions and polypharmacy. - 4. Preclinical and clinical investigation of antipsychotic polypharmacy: What is the evidence?. - 5. Should high dose or very long-term antipsychotic monotherapy be considered before antipsychotic polypharmacy?. - 6. Multiple Medication Use of Neuropsychiatry in Forensic Psychiatry: Findings from the Central State Forensic Psychiatric Hospital of Saxony-Anhalt. - 7. Antipsychotic treatment within a naturalistic trial - how are we treating schizophrenia patients in the "real-world"?. - 8. A multi-target drug treatment in schizophrenia using adjunctive agents with non-D2 mechanisms of action. - 9. Antidepressants in schizophrenia - a place for them?. - 10. Stressful life events and anticonvulsant medication in psychiatric patients. - 11. Multiple medication use in somatic symptom disorders: from augmentation to diminution strategies.
Summary
Although monotherapy is generally recommended as the treatment of choice, treatment resistance of patients with psychosis, cognitive, mood and anxiety disorders represents a significant clinical problem. In this context, augmentation and combination strategies are commonly employed to address this problem. Although multiple medication use common in psychiatric practice, reasons, efficacy and safety for polypharmacy, and augmentative strategies have remained unclear. It remains unclear if there is an evidence base to support polypharmacy. Furthermore, excessive and inappropriate use of psychotropic medications has been recognized as a public health problem. This volume set is the first comprehensive, clinically oriented, reference on the multiple medication use to treat psychotic, cognitive, mood and anxiety disorders.
Additional text
From the reviews:
“This is part of a two-volume set that is the first comprehensive, clinically oriented reference that looks at the evidence regarding the use of multiple medications in the treatment of a variety of mental illnesses. … should be read by anyone involved in the pharmacological management of psychiatric illnesses.” (Michael Easton, Doody’s Book Reviews, July, 2013)
Report
From the reviews:
"This is part of a two-volume set that is the first comprehensive, clinically oriented reference that looks at the evidence regarding the use of multiple medications in the treatment of a variety of mental illnesses. ... should be read by anyone involved in the pharmacological management of psychiatric illnesses." (Michael Easton, Doody's Book Reviews, July, 2013)
