Multiple drug therapy questioned

Schizophrenics who took two anti-psychotic drugs showed no more improvement than those on a single drug, raising doubts about the benefit of using multiple medications to treat the disease, a study said yesterday.

The study, published in The New England Journal of Medicine, tested 68 patients who responded poorly to clozapine, the generic version of Clozaril, which is made by Novartis AG.

Half the group took clozapine and Risperdal, an antipsychotic drug produced by Johnson & Johnson. The other half were given clozapine and a placebo. Both groups showed the same degree of improvement during the 26-week trial, but there was a slight deterioration in memory among the ones taking Risperdal.

William Honer, the study's chief author, said the results offer no support for the idea of prescribing multiple drugs, at least from the same class, especially to people who did not improve while taking clozapine.

Schizophrenia can trigger delusions, paranoia, and hallucinations, and one-third of patients are not helped by established medications. As a result, doctors combine medicines in as many as half of all schizophrenia cases, Honer said. ''Using two anti-psychotic drugs together is quite common," he said in an interview. ''We've seen patients taking up to five."

In an editorial in the Journal, John Davis of the University of Illinois at Chicago said the results should not be considered definitive. He said two other studies, funded by the pharmaceutical industry, indicated patients did better when they took the two drugs, perhaps because higher doses of Risperdal were used than in the Honer trial, which was not sponsored by the industry.