In the pharmacological treatment of psychotic disorders, evidence-based treatment recommendations suggest the prescription of one antipsychotic (monotherapy) where possible. The simultaneous co-prescription of multiple antipsychotics, known as antipsychotic polypharmacy (APP) has recently been the subject of much discussion and research in the scholarly literature. There are concerns regarding the cost, lack of efficacy, and iatrogenic potential of APP. This study examines clinical and demographic variables related to the prescription of APP among 267 state hospital inpatients. APP was operationalized as co-prescription of ''2 antipsychotics for ''60 days. Inpatients were categorized as recipients of either APP or monotherapy. Monotherapy and APP groups were then compared descriptively across demographic and clinical variables. Demographic variables included age, race, education, and marital status. Clinical variables included seclusion and restraint incidents, number of lifetime admissions, and medical comorbidity, as well as PANSS and GAF scores. There were 95 patients (35.6%) who had at least one episode of APP. There was no clinically significant association between polypharmacy status and race, age, or PANSS scores. Patients prescribed multiple antipsychotics were more likely to be male (OR=2.57), to have been hospitalized over a year (OR=3.12), to have never been married (OR=1.69), and to have ''1 career incident of seclusion and restraint (OR=2.46). Diagnoses of hyperlipidemia (OR=1.5) and adverse neurological effects (OR=1.54) were also associated with an increased risk of APP. Overall, these findings suggest that antipsychotic polypharmacy is a highly individualized treatment decision not well explained by the available clinical and demographic variables. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Summer Semester, 2008. / June 2, 2008. / Includes bibliographical references. / Tomi Gomory, Professor Directing Dissertation; Bruce Bullington, Outside Committee Member; C. Aaron McNeece, Committee Member.
| Identifer | oai:union.ndltd.org:fsu.edu/oai:fsu.digital.flvc.org:fsu_183626 |
| Contributors | Lacasse, Jeffrey Raymond (authoraut), Gomory, Tomi (professor directing dissertation), Bullington, Bruce (outside committee member), McNeece, C. Aaron (committee member), College of Social Work (degree granting department), Florida State University (degree granting institution) |
| Publisher | Florida State University, Florida State University |
| Source Sets | Florida State University |
| Language | English, English |
| Detected Language | English |
| Type | Text, text |
| Format | 1 online resource, computer, application/pdf |
| Rights | This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). The copyright in theses and dissertations completed at Florida State University is held by the students who author them. |
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