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The Natural History of Initial Antipsychotic Treatment Among Men Admitted to a State Prison
Theodore R Zarzar1, David L Rosen1, Michael T Kane1
1Department of Psychiatry (Zarzar, Kane) and Department of Medicine (Rosen), University of North Carolina School of Medicine, Chapel Hill; North Carolina Department of Public Safety-Prisons, Raleigh, North Carolina (Sheitman).
Objective:
This study examined the natural history of antipsychotic medication treatment for men with a psychotic disorder who entered the North Carolina prison system in 2016-2017.
Methods:
The authors used prison records to identify individuals with a psychotic illness who were prescribed an index antipsychotic medication on prison entry (N=245). Data were analyzed to determine persistence of antipsychotic therapy and potential associations with treatment discontinuation.
Results:
About 28% of the patients had stopped their antipsychotic medication by day 50; the median time until stopping was 248 days (95% confidence interval=147-355). Younger patients and those not continuing a preincarceration medication regimen discontinued treatment sooner than their respective counterparts.
Conclusions:
The early weeks of incarceration are a period of increased risk for antipsychotic discontinuation, particularly among younger individuals and those prescribed a new medication. These findings may help guide prison systems in implementing interventions that reduce antipsychotic treatment interruptions.
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