A framework to avoid irrational polypharmacy in psychiatry
Bibliographic record
Abstract
Many patients with psychiatric disorders do not obtain remission from available pharmacological and psychotherapeutic treatments. Recent studies have demonstrated that there is a role for the rational use of 'combination therapy' when treating patients with serious and treatment-resistant mental illnesses. When prescribing multiple medications, it is easy, however, to fall into irrational polypharmacy. We present a framework that clinicians can use to avoid the pitfall of irrational polypharmacy. When using combination therapy, clinicians should consider: (a) pharmadynamic redundancy; (b) pharmacodynamic interactions; (c) pharmacokinetic interactions; and (d) avoid inadequate dosing of medications. Clinicians should also (e) regularly reassess the need for and benefit of continued combination therapy.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.029 | 0.022 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.004 | 0.001 |
| Science and technology studies | 0.009 | 0.036 |
| Scholarly communication | 0.008 | 0.012 |
| Open science | 0.004 | 0.013 |
| Research integrity | 0.013 | 0.019 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".