Two articles in this issue of JAMA Psychiatry explore adjunctive treatments for individuals with schizophrenia using large, observational data sets. Results from randomized clinical trials (RCTs) of adjunctive pharmacologic treatments in schizophrenia have been inconsistent and often difficult to interpret because of poor quality.1 Although RCTs are the standard for evaluating the efficacy of an intervention, they are costly, are not always feasible, and the results may not be generalizable to typical clinical populations. In addition, high placebo response rates and heterogeneity of illness further limit our ability to detect an efficacy signal. In the absence of data from large and methodologically rigorous RCTs, we must avail ourselves of other sources of data to identify potential therapeutic approaches.
Goff DC. Can Adjunctive Pharmacotherapy Reduce Hospitalization in Schizophrenia? Insights From Administrative Databases. JAMA Psychiatry. Published online February 20, 201976(5):468–470. doi:10.1001/jamapsychiatry.2018.4318
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