Polypsychopharmacy Revisited

Abstract

In this paper, polypsychopharmacy is defined, noting variations of definition in the medical literature. We show that the high incidence rates are not dependent only on the physician's behaviour. Much of the medical literature is hostile to the use in psychiatry of two-drug combinations, and this hostility is based on three assumptions about drug use. We find little evidence to support these assumptions. Attempts to reduce the incidence of polypsychopharmacy may be simply irrelevant. We list several two-drug combinations which are of value in psychiatry, and then return to two questions:

1) Why is there so little research into two-drug combinations, considering their high incidence of use?

2) Why does this high incidence persist in the absence of good supportive evidence of its value?

We offer tentative responses to these questions, and conclude that since multiple drug use is as likely to be of value in psychiatry as in any other branch of medicine, research into specific drug-combinations is overdue.