Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Kreyenbuhl, J. A. Articles by Blow, F. C. Search for Related Content PubMed Citation Articles by Kreyenbuhl, J. A. Articles by Blow, F. C. Veterans Other Health Services Issues Atypical Neuroleptics Conventional Neuroleptics Schizophrenia Spectrum Disorders Antidepressants Related Article

Long-Term Antipsychotic Polypharmacy in the VA Health System: Patient Characteristics and Treatment Patterns

OBJECTIVE: Although antipsychotic polypharmacy is being prescribed with increasing frequency, few studies have described patient characteristics and treatment patterns associated with long-term use of this treatment strategy. METHODS: By using data from the National Psychosis Registry of the Department of Veterans Affairs, 5,826 patients with schizophrenia or schizoaffective disorder who received long-term antipsychotic polypharmacy (simultaneous treatment with two or more antipsychotics for 90 or more days) during fiscal year 2000 and 39,745 patients who received long-term antipsychotic monotherapy were identified. By using multivariate regression models, patient demographic and clinical characteristics, antipsychotic dosages, and use of antiparkinson and adjunctive psychotropic medications were compared between the two groups. RESULTS: Patients were more likely to receive antipsychotic polypharmacy if they were younger, were unmarried, had a military service-connected disability, had schizophrenia rather than schizoaffective disorder, or had greater use of inpatient and outpatient mental health services. Patients were less likely to receive antipsychotic polypharmacy if they were African American, had concurrent diagnoses of depression or substance use disorder, or had greater medical comorbidity. For most antipsychotics, dosages prescribed for patients receiving polypharmacy were the same or modestly higher than those prescribed for patients receiving monotherapy. Patients given prescriptions for polypharmacy were more likely to receive antiparkinson medications, antianxiety agents, and mood stabilizers and equally likely to receive concurrent treatment with antidepressants. CONCLUSIONS: Long-term antipsychotic polypharmacy appears to be reserved for more severely ill patients with psychotic symptoms rather than mood symptoms. These patients may experience increased adverse effects as a result of excess antipsychotic exposure.

Related Article:

April 2007: This Month's Highlights
Psychiatr Serv 2007 58: 441. [Full Text] [PDF]

This article has been cited by other articles:

				A. J Wheeler Treatment Pathway and Patterns of Clozapine Prescribing for Schizophrenia in New Zealand Ann. Pharmacother., June 1, 2008; 42(6): 852 - 860. [Abstract] [Full Text] [PDF]

				J. P. Babbar Polypharmacy and Adverse Drug Reactions Psychiatr Serv, July 1, 2007; 58(7): 1011 - 1011. [Full Text] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 2007 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us