title: Efficacy and clinical determinants of antipsychotic polypharmacy in psychotic patients experiencing an acute relapse and admitted to hospital stay: results from a cross-sectional and a subsequent longitudinal pilot study.
abstract: Background. Antipsychotic polypharmacy is used in several psychiatric disorders, despite poor evidence existing to support this practice. Aim. We evaluated whether psychotic patients in acute relapse exposed to antipsychotic polypharmacy (AP + AP) showed different demographic, clinical, or psychopathological features compared to those exposed to one antipsychotic (AP) and whether AP + AP patients showed significantly higher improvement compared to AP patients after a 4-week treatment. Methods. Inpatients were subdivided into AP + AP and AP ones. In the cross-sectional step, patients were compared according to demographics, clinical variables, and scores on rating scales. In the longitudinal step, patients remained for 4 weeks under admission medications and were compared for clinical improvement. Results. AP + AP patients were more frequently diagnosed with schizophrenia and mental retardation as a comorbid illness. AP + AP patients were more frequently under first-generation antipsychotics and had worse clinical presentation. After 4 weeks of treatment, both AP + AP and AP patients improved compared to the baseline. However, AP patients scored significantly less than AP + AP patients at the Clinical Global Impression Scale at the 4-week time point but not at the baseline, indicating a treatment-specific improvement. Conclusions. Antipsychotic polypharmacy may be offered to specific types of psychotic patients. However, efficacy of this strategy is limited at best.
authors.affiliation: Department of Neuroscience, Reproductive Sciences and Odontostomatology, University "Federico II" of Naples, Via Pansini 5, 80131 Naples, Italy.
authors.forename: Felice
authors.identifier: 0000-0002-7051-5013
authors.initials: F
authors.lastname: Iasevoli
authors.affiliation: Department of Neuroscience, Reproductive Sciences and Odontostomatology, University "Federico II" of Naples, Via Pansini 5, 80131 Naples, Italy.
authors.forename: Elisabetta F
authors.initials: EF
authors.lastname: Buonaguro
authors.affiliation: Hermanas Hospitalarias, Villa San Giuseppe Hospital, 63100 Ascoli Piceno, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Marconi
authors.affiliation: Hermanas Hospitalarias, Villa San Giuseppe Hospital, 63100 Ascoli Piceno, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Di Giovambattista
authors.affiliation: Hermanas Hospitalarias, Villa San Giuseppe Hospital, 63100 Ascoli Piceno, Italy.
authors.forename: Maria Paola
authors.initials: MP
authors.lastname: Rapagnani
authors.affiliation: NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, 64100 Teramo, Italy ; Department of Neurosciences and Imaging, University "G. d'Annunzio" of Chieti, 66013 Chieti, Italy.
authors.forename: Domenico
authors.identifier: 0000-0003-4415-5058
authors.initials: D
authors.lastname: De Berardis
authors.affiliation: Department of Neurosciences and Imaging, University "G. d'Annunzio" of Chieti, 66013 Chieti, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Martinotti
authors.affiliation: Department of Life, Health and Environmental Sciences, University of L'Aquila, 67010 L'Aquila, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Mazza
authors.affiliation: Department of Neuroscience, Reproductive Sciences and Odontostomatology, University "Federico II" of Naples, Via Pansini 5, 80131 Naples, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Balletta
authors.affiliation: NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, 64100 Teramo, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Serroni
authors.affiliation: Department of Neurosciences and Imaging, University "G. d'Annunzio" of Chieti, 66013 Chieti, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Di Giannantonio
authors.affiliation: Department of Neuroscience, Reproductive Sciences and Odontostomatology, University "Federico II" of Naples, Via Pansini 5, 80131 Naples, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: de Bartolomeis
authors.affiliation: Hermanas Hospitalarias, Villa San Giuseppe Hospital, 63100 Ascoli Piceno, Italy ; FORIPSI, 00199 Rome, Italy.
authors.forename: Alessandro
authors.identifier: 0000-0003-3378-6831
authors.initials: A
authors.lastname: Valchera