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Combination Atypical Antipsychotics in Adolescents or Adults with Schizophrenia: A Review of Clinical and Cost-Effectiveness and Guidelines

Last updated: August 30, 2016
Project Number: RC0805-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of combination AAPs in adolescent or adult patients with schizophrenia?
  2. What is the cost-effectiveness of combination AAPs in adolescent or adult patients with schizophrenia?
  3. What are the evidence-based guidelines associated with the use of combination AAPs in adolescent or adult patients with schizophrenia?

Key Message

Limited evidence suggested that combination of CLZ with ARI had some clinical benefits over CLZ monotherapy, whereas other AAPs had no clinical or statistically significant impact on the reduction of psychotic symptoms. Combination AAP therapy may increase serum prolactin levels, and decrease weight gain and body mass index (BMI); however combination AAP therapy may also increase agitation. The evidence on clinical effectiveness focused primarily on adults and not on adolescents. No relevant economic evaluations were identified. Clinical guidelines offer combination AAP therapy under trial conditions as an option after serial dose-optimized regimen of monotherapy have failed.