Clinical sequelae of overt non-compliance with psychotropic agents

A group of 487 patients admitted to Eastern State Hospital in Lexington, Kentucky, during a 3-month period were prospectively followed to determine the incidence of psychotropic medication refusal, unique characteristics of refusers, factors leading to refusal, and clinical outcome of those who refused. Patients who refused any dose(s) of psychotropic medications were identified within 24 hours of refusal. For patients who refused for 24 hours or more, the psychiatrist was asked to complete a 4-item questionnaire. Our data indicate that medication refusal leads to poorer clinical outcomes, as measured by length of hospitalization and incidence and duration of restraint episodes.