One drug better than many according to study

You gotta wonder about some articles coming out these days. Take the article Antipsychotic Monotherapy Worth a Try in Medscape Today, for instance.

Adult outpatients with schizophrenia who are receiving antipsychotic polypharmacy can be safely tried on monotherapy, according to new research published in the July issue of the American Journal of Psychiatry.

Well, to be more truthful about the matter, one drug is apt to harm a patient less than the use of multiple drugs. Drug cocktails, just like with mixed drinks, can prove more potent than even a higher dose of a single drug alone.

The rate of polypharmacy ranges from 10% to 30% and is increasing, despite lack of studies, Dr. Covell said. “We wanted to take a closer look because there are added risks to taking more than 1 medication. You’re exposed to the side effects from both, there’s extra cost, all without any evidence as to whether polypharmacy is more effective.”

My understanding of the matter is that the evidence from research shows polypharmacy is less effective than what this article calls “antipsychotic monotherapy”, and that not introducing neuroleptic drugs at all works more effectively than both polypharmacy and “antipsychotic monotherapy”, long term anyway.

Switching from polypharmacy to “monotherapy” was associated with weight loss in this study; patients who continued in polypharmacy gained weight.

Some of these psychiatrists unfortunately have the mistaken belief that treatment noncompliance is a good justification for the practice of polypharmacy.

They [Dr. Donald C. Goff and Dr. Lisa Dixon] note that relatively few patients continue to receive a single antipsychotic agent for long, and adherence is often poor, even with monotherapy.

It should be remembered that the ultimate aim of such therapy should be mental health recovery, or no drug use. I think doctors have a way of forgetting this fact.

Once you reach the bottom of the page you find Dr. Susan M. Essock, one of the lead researchers in this study, and Dr. Nancy H. Covell, the author quoted in the article, have no disclosed to ties to drug companies. The case of Professors Dr. Donald C. Goff and Dr. Lisa Dixon, the two doctors who against all reason defend polypharmacy, is a little more muddy. Fully 25 pharmaceutical companies are listed after Professor Goff’s name while Dr. Dixon had ties with one drug manufacturer listed after her name. I suspect you could say, in this instance, the record speaks for itself.