Strategies for Reducing Antipsychotic Polypharmacy

Abstract

Antipsychotic polypharmacy (the use of two or more antipsychotics at the same time) is an increasingly common practice even though consensus treatment guidelines do not recommend it. Multiple studies have examined algorithms, decision supports, and educational strategies to change prescriber behaviors. We describe the case study of a young adult with schizoaffective disorder who transferred from residential treatment to an outpatient assertive community treatment for co-occurring disorders, presenting treatment-resistant psychotic and mood disorder symptoms and experiencing intolerable side effects from substantial polypharmacy. This case exemplifies how integrating wellness-oriented strategies, such as mindfulness training and exercise, into treatment and encouraging people to apply these strategies to address persistent symptoms might facilitate reductions in antipsychotic polypharmacy among those with co-occurring disorders.

Keywords:

• mindfulness
• exercise
• polypharmacy
• antipsychotic
• psychosis
• schizophrenia
• addiction
• substance abuse
• wellness
• co-occurring disorder