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A Pilot Study Exploring the Impact of Pro Re Nata Medication Utilization on Aggression in Forensic Psychiatric
Gabrielle Morgan1, O Greg Deardorff2, Raja Hussain3
1Morgan, PharmD, Department of Pharmacy, Fulton State Hospital, Fulton, MO; Department of Pharmacy, CPS Solutions LLC, Dublin, OH.
Psychopharmacology Bulletin
|January 14, 2026
Summary
This study found no consistent group-level patterns in pro re nata (PRN) medication use around aggressive incidents in forensic psychiatric patients. Individual patient patterns may be more informative for treatment planning.
Area of Science:
- Forensic Psychiatry
- Psychopharmacology
- Clinical Psychology
Background:
- Aggressive incidents are a concern in forensic psychiatric facilities.
- Pro re nata (PRN) medications are frequently used to manage acute symptoms, including aggression.
- Understanding PRN medication utilization patterns surrounding aggression is crucial for effective treatment.
Purpose of the Study:
- To analyze patterns of PRN medication utilization (psychotropic and somatic) in the seven days before and after aggressive incidents.
- To identify trends in PRN use in relation to aggression within a forensic setting.
Main Methods:
- Retrospective chart review at a long-term state forensic psychiatric facility.
- Inclusion of patients receiving PRN medications during a six-month period.
- Analysis of PRN utilization surrounding 322 aggressive incidents.
Main Results:
- No significant difference in psychotropic versus somatic PRN use was found in the seven-day periods surrounding aggression.
- Neither psychotropic nor somatic PRN use showed a meaningful deviation from baseline levels.
- PRN utilization rates were higher than baseline in 38.8% of aggressive incidents.
Conclusions:
- No consistent group-level trends in PRN utilization were identified in relation to aggression.
- Individualized patient-level variations in PRN use were observed post-incident.
- Monitoring individual PRN utilization patterns can inform personalized treatment planning.
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