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Antipsychotic polypharmacy common after discharge from inpatient psychiatric hospitals

Recent findings indicated antipsychotic polypharmacy among 12% of individuals discharged from a state psychiatric inpatient hospital.

“Despite the lack of empirical evidence that antipsychotic polypharmacy produces superior outcomes to antipsychotic monotherapy, clinicians continue to prescribe multiple antipsychotic medications for patients with a diagnosis of schizophrenia,” Glorimar Ortiz, MS, of the National Association of State Mental Health Program Directors Research Institute, and colleagues wrote. “There is clear evidence that antipsychotic polypharmacy presents complications for the patient, including risk of drug interactions, increased medication side effects, increased risk for metabolic disorders, and complex medication regimens, which may lead to medication nonadherence among patients.”

To assess antipsychotic medication prescribing practices among individuals discharged from state psychiatric inpatient hospitals, researchers conducted a cross-sectional study among 86,034 adult patients discharged in 2011.

Overall, prevalence of antipsychotic polypharmacy was 12%.

Among participants receiving at least one antipsychotic, 18% were prescribed multiple antipsychotics.

Having a diagnosis of schizophrenia and length of stay of 90 days or more were the most significant predictors of antipsychotic polypharmacy.

The primary reason for antipsychotic polypharmacy was to reduce symptoms.

“Antipsychotic polypharmacy continues at a high enough rate to impact nearly 10,000 patients with a diagnosis of schizophrenia each year in state psychiatric inpatient hospitals. Given such a large sample, further analysis of the clinical presentations of these patients may highlight particular aspects of the illness and its previous treatment that are contributing to practices outside the best practice guidelines,” the researchers concluded. – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.