The Problem of Antipsychotic Polypharmacy: Page 2 of 2

July 21, 2016

Further, most of the existing literature on antipsychotic polypharmacy is based on Medicaid claims data, which exclude data for individuals discharged from state psychiatric inpatient hospitals.

“These hospitals now have the opportunity to benchmark their antipsychotic medication use rate with national rates more accurately, and, therefore, develop and implement performance improvement activities that are more precise,” she said.  

The authors call for further research on such topics as examining the number of antipsychotic medications on admission and alterations in these medication regimens during one’s hospital stay, as well as the adherence to medication regimens involving multiple antipsychotics after discharge. Information on how the antipsychotic medication prescribing practices change from admission, during hospital stay, and at discharge will further guide best practice activities at the patient level, Ms. Ortiz noted.

“There are a group of characteristics that increase the likelihood of being discharged on multiple antipsychotic medications, with the strongest factors being a diagnosis of schizophrenia and longer hospitalizations,” she said of their findings. “Clinicians could use this information to develop and implement quality initiatives that could help further reduce the use of antipsychotic polypharmacy.”

The ultimate take-home message of this study is that there is still a large number of patients who are being discharged from state psychiatric hospitals on multiple antipsychotic medications, explained Ms. Ortiz.

“Clinicians reported using multiple antipsychotics primarily to reduce patient symptoms, which is currently not seen by The Joint Commission or the Centers for Medicare & Medicaid Services as a justifiable reason for antipsychotic polypharmacy,” she said. “Our findings may suggest that more research should be done on the reasons for using of multiple antipsychotic medications for persons with schizophrenia, before performance measurement financial sanctions are imposed by accrediting agencies.”   

This study was published in the Journal of Psychiatric Practice.


-Meredith Edwards White



Ortiz G, Hollen V, Schacht L. Antipsychotic medication prescribing practices among adult patients discharged from state psychiatric inpatient hospitals. J Psychiatr Pract. 2016;22(4):283-297.