Emerging guidelines for the use of antipsychotic polypharmacy.

Although combining medications for the treatment of schizophrenia is the rule rather than the exception, the literature and treatment guidelines consistently direct clinicians away from this practice, emphasizing that antipsychotic polypharmacy/combination treatments are associated with higher medication costs, more side effects, and no clearly documented improvement in efficacy and in fact, worse outcomes. However, the tide may be beginning to turn in favor of antipsychotic polypharmacy for selected patients. Who are these patients and what are the emerging guidelines for using antipsychotic polypharmacy?