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Antipsychotic combination using low-dose antipsychotics is as efficacious and safe as, but cheaper, than optimal-dose monotherapy in the treatment of schizophrenia: a randomized, double-blind study

Lin, Ching-Huaa,b,c; Wang, Fu-Chianga; Lin, Shih-Chia; Huang, Yu-Huia; Chen, Cheng-Chunga; Lane, Hsien-Yuand,e

International Clinical Psychopharmacology: September 2013 - Volume 28 - Issue 5 - p 267–274
doi: 10.1097/YIC.0b013e3283633a83
Original Articles

The use of antipsychotic combination has been increasing during the last decade. This study aimed to compare the efficacy and safety of low-dose amisulpride plus low-dose sulpiride with full-dose amisulpride in the treatment of acute schizophrenia. In this 6-week, double-blind, fixed-dose study, patients were randomized to antipsychotic combination (400 mg/day amisulpride plus 800 mg/day sulpiride, N=46) or monotherapy (800 mg/day amisulpride, N=46) groups. Efficacy measurements included the Positive and Negative Syndrome Scale (PANSS) and subscales, and other scales. Safety and quality of life were also assessed. Response was defined as a 30% reduction in the PANSS total score. Both groups were similar in terms of the following: (a) clinical characteristics at baseline, (b) response rates, and (c) score changes in all psychopathology measures, quality of life, and all side-effect scales after 6 weeks of treatment. There were also no significant between-group differences in changes in other safety measurement. However, the combination strategy did reduce treatment costs. The current study suggests that an antipsychotic combination of low-dose antipsychotics is as efficacious and safe as, but cheaper than, optimal-dose monotherapy in the treatment of schizophrenia.

aDepartment of Adult Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital

bDepartment of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University

cDepartment of Nursing, Fooyin University, Kaohsiung

dDepartment of Psychiatry, China Medical University Hospital, Taichung, Taiwan

eInstitute of Clinical Medical Science, China Medical University, Taichung, Taiwan

Correspondence to Hsien-Yuan Lane, MD, PhD, Department of Psychiatry, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taiwan Tel: +886 921 067 260; fax: +886 4 2236 1042; e-mail:;

Received January 28, 2013

Accepted May 7, 2013

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins