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  Česky / Czech version Čes. a slov. Psychiat., 99, 2003, No. 4, pp. 189 - 193.
 
Polypharmacotherapy – When it is Treatment of the First or Second Choice? Part II. 
Češková E., Kašpárek T. 

Psychiatrická klinika LF MU a FN, Brno, přednosta prof. MUDr. E. Češková, CSc.
 


Summary:

       Polypharmacotherapy is very frequently used in the bipolar and psychotic depression and in the pharmacoresistant schizophrenia. For all these indications only a few controlled double-blind studies are available. Emergence of atypical antipsychotics represents another aspect of the problem. In the bipolar depression, mood stabilizers or their combinations are adequate for mild depression only. In more severe depression the transitory use of combinations with antidepressants is recommended; in resistant and psychotic depression combinations with atypical antipsychotics can be temporally used. In pharmacoresistant schizophrenia the augmentation strategies (lithium, anticonvulsants) are not applied very often, the combinations of several antipsychotics with different and mutually complementary pharmacological profile have been employed more frequently. Such combinations should be used after a trial of monotherapy with clozapine.

        Key words: polypharmacotherapy, bipolar depression, psychotic depression, pharmacoresistant schizophrenia, combination, augmentation.
       

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