Use of concomitant medication in the treatment of schizophrenia

Abstract

Schizophrenia is a lifelong disorder that requires continuous pharmacotherapy. About 10 to 30% of patients with schizophrenia show poor response to antipsychotic medication alone, therefore concomitant medication is often used. The rationale for the addition of concomitant medication is often unclear and based on limited evidence. The most frequently prescribed concomitant medications in the treatment of schizophrenia include anticholinergic medication, antidepressants, anxiolytics for example, benzodiazepines, lithium and anticonvulsant medication for example, valproex. Indications for adding these medications to antipsychotic treatment regimens vary from controlling specific symptoms associated with schizophrenia for example, anxiety symptoms, aggressive behavior and suicidality, to managing adverse effects for example, parkinsonian side effects caused by antipsychotic medication. Although there is a need for concomitant medication in the treatment of schizophrenia, each patient needs to be assessed individually since the use of concomitant medication can also have negative treatment implications, for example an increase in the occurrence of adverse effects and drug interactions. Due to the diversity of the disease profile of schizophrenia, no one adjunctive treatment benefits all patients, therefore the choice of specific treatment is best guided by the clinical characteristics and presentation of the individual patient. The aim of this paper is thus to present a qualitative review of the literature.