Should doctors prescribe two antipsychotic drugs to be taken at the same time?

Professor David Taylor: The prescribing of 2 antipsychotics at the same time is pretty common both in the UK and abroad. It’s been common for a long time, since the 1960s and it seems that the rate of prescribing 2 or 3 antipsychotics together doesn’t differ very much between countries, and hasn’t changed very much over time.

Now what we take from that, is that although there’s no scientific evidence to support the use of 2 medications, or 3, of 2 or 3 antipsychotics, prescribers seem to be aware that in particular cases the prescribing of 2 antipsychotics is better than the prescribing of one.

When you look at the scientific evidence, there’s a little bit of support for using clozapine with another antipsychotic in certain situations, but there isn’t a great deal of support for other drugs in combination.

And one of the problems, perhaps the biggest problem with this area, is that there are so many antipsychotics, and it might be 30 that could be used in this country, you would have to look at every single combination compared to a single drug in order to find out which was better and you’ve got literally hundreds of combinations to study. There’s no financial interest for anybody in doing these studies, so we’ll never really know whether 2 antipsychotics are better than one, but practical experience suggests that for some people, that 2 antipsychotics might be better and scientific evidence suggests there might be a small benefit again in some people.