How many medicines should I be taking for my symptoms of psychosis?
There are no easy answers to this and it is a very individual choice. Generally one medicine should always be the aim but combinations (often called “polypharmacy”) sometimes help. It is rarely of any use to combine drugs with similar ways of working. Below are some of the combinations that are used with the reasons. This is not a complete list but you might want to talk to your prescriber about any combinations not on this list you may be prescribed.
Although combinations of antipsychotics have been used quite a lot, the general aim is to get the best out of one antipsychotic e.g. fiddle with the dose and timings to get the best effect with the least side effects. Sometimes adding another antipsychotic to clozapine is tried if clozapine has only been partly effective.
| Main medicine | Second medicine | Reason |
|
Clozapine |
Other antipsychotics such as risperidone, sulpiride, quetiapine, amisulpride or aripiprazole |
Clozapine has been only partly effective or to help reduce side effects |
|
Any antipsychotic |
A benzodiazepine e.g. lorazepam, clonazepam or diazepam |
For someone who is agitated, especially if acutely unwell |
|
Any antipsychotic |
An anticholinergic e.g. procyclidine or orphenadrine |
The anticholinergic would be to help reduce some of the side effects you might get from an antipsychotic, such as muscle stiffness, tremor and shaking. |
|
Clozapine |
An anticonvulsant such as sodium valproate (e.g. Epilim or Depakote) |
Clozapine can make you more likely to have a seizure or fit, especially if you are taking more than 600mg in a day. Valproate will much reduce the chances of a fit. |