A description of antipsychotic prescribing patterns on the inpatient behavioral health setting - Multicenter cross-sectional analysis

Q: What is the study designed to measure?

The study measures antipsychotic prescribing patterns at inpatient discharge, with primary outcomes being Total Chlorpromazine Equivalent Dosing (TCPZE) and clinician adherence to FDA guidance.

Q: Which factors were linked to higher antipsychotic doses at discharge?

Male gender, no social support, more previous antipsychotic trials, and longer hospital stays were statistically associated with higher antipsychotic doses at discharge.

Q: Which patient groups were less likely to follow FDA and guideline-recommended antipsychotic use?

Patients with comorbid diabetes, those receiving more antipsychotics at discharge, and those with Medicare insurance were less likely to receive antipsychotic therapy according to FDA recommendations and current guidelines.

Sep 30, 2026

Uploaded by Ben

Antipsychotic therapy benefits individuals with schizophrenia and other psychiatric diagnoses, but adverse events—including movement disorders and metabolic concerns—can occur even at low doses. This multicenter retrospective cross-sectional chart review analyzes 785 inpatient cases to characterize antipsychotic prescribing patterns at discharge, focusing on Total Chlorpromazine Equivalent Dosing (TCPZE) and clinician adherence to FDA guidance. Higher TCPZE dosing at discharge is associated with male gender, lack of social support, more prior antipsychotic trials, and longer hospital stays, while diabetes, more antipsychotics at discharge, and Medicare coverage correlate with lower adherence. Results inform prescribing practice and motivate broader prospective studies during acute illness.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Background

Objectives

Design

Methods

Results

Conclusion

Keywords

TherapeuTic advances in psychopharmacology Original Research | A description of antipsychotic prescribing patterns on the inpatient behavioral health setting: a multicenter cross-sectional analysis
Thomas Maestri, David Anderson and Margarita Echeverri
Abstract
Background: Antipsychotic therapy can bring a great deal of benefit to individuals with schizophrenia and other psychiatric diagnoses, though this class of medications is also associated with intolerabilities due to possible adverse events. Notable adverse events commonly experienced include movement disorders and metabolic concerns that can occur even at low doses and minimal exposure.
Objectives: Describe the prescribing patterns of antipsychotics in the inpatient behavioral health setting, and report on characteristics that lead to populations having higher or lower dosing exposures to antipsychotic therapy that follows FDA guidelines.
Design: Multicentered, retrospective, cross-sectional chart review.
Methods: The study was conducted at two academic hospitals in the inpatient behavioral health setting. Information was collected on 785 cases of patients who were hospitalized during the study period with a psychiatric diagnosis that necessitated a prescription for an antipsychotic medication at the time of discharge. Differences in antipsychotic drug (dose, type, number, and duration of treatment) were characterized, and data were collected on clinician adherence to FDA guidance, as listed in the package insert of each antipsychotic drug. Primary outcomes were the amount of Total Chlorpromazine Equivalent Dosing doses and the clinician's adherence to FDA guidance.
Results: This study found that the male gender (p < 0. 0001), no social support (p < 0. 0025), more previous antipsychotic trials (p < 0. 0001), and longer hospital stays (p < 0. 0001) were statistically significant for patients receiving higher antipsychotic doses at discharge. Additionally, patients with comorbid diabetes (p < 0. 0001), more antipsychotics at discharge (p = 0 . 001), and Medicare insurance (p = 0 . 005) were less likely to receive antipsychotic medication following FDA recommendations and current guidelines.
Conclusion: The results of this study can inform practice regarding antipsychotic prescribing patterns in different populations. Conducting prospective studies across a broader range of institutions, it is recommended to better understand the relationship between patient demographics and prescribing patterns during periods of acute illness.
Keywords: acute care behavioral health, antipsychotic prescribing patterns, schizophrenia and other psychiatric diagnoses, total chlorpromazine equivalent dosing (TCPZE) doses
Received: 6 February 2025; revised manuscript accepted: 16 October 2025. | | TherAdv Psychopharmacol 2026, Vol. 16: 1–12
DOI: 10. 1177/
20451253251394296 © The Author(s), 2026. Article reuse guidelines:
[sagepub.com/journals](sagepub.com/journals)permissions
Correspondence to:
Thomas Maestri
Xavier University of Louisiana, 1 Drexel Dr, New Orleans, LA 70125- 1056, USA
[tmaestri@xula.edu](tmaestri@xula.edu)
David Anderson Margarita Echeverri
Xavier University of Louisiana, New Orleans, LA, USA | | --- | --- | --- | | Background
Antipsychotics are a commonly prescribed class of medications for psychiatric disorders. | Antipsychotics are often administered along with non-pharmacologic therapies to assist in improving patient prognosis in a multitude of psychiatric | | [journals.sagepub.com/home/tpp](journals.sagepub.com/home/tpp) 1 Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is

FAQs

What is the study designed to measure?

The study measures antipsychotic prescribing patterns at inpatient discharge, with primary outcomes being Total Chlorpromazine Equivalent Dosing (TCPZE) and clinician adherence to FDA guidance.

Which factors were linked to higher antipsychotic doses at discharge?

Male gender, no social support, more previous antipsychotic trials, and longer hospital stays were statistically associated with higher antipsychotic doses at discharge.

Which patient groups were less likely to follow FDA and guideline-recommended antipsychotic use?

Patients with comorbid diabetes, those receiving more antipsychotics at discharge, and those with Medicare insurance were less likely to receive antipsychotic therapy according to FDA recommendations and current guidelines.

Sep 30, 2026

Uploaded by Ben