Antipsychotic factors related to time to competency for forensic inpatients in a state psychiatric facility.

Autor:	Lemons A; Psychiatric Pharmacy Resident, Missouri Department of Mental Health, Center for Behavioral Medicine, Kansas City, Missouri; Clinical Psychiatric Pharmacist, Denver Health Medical Center, Denver, Colorado., Iuppa CA; Psychiatric Pharmacy Resident, Missouri Department of Mental Health, Center for Behavioral Medicine, Kansas City, Missouri; Clinical Psychiatric Pharmacist, Denver Health Medical Center, Denver, Colorado.; Clinical Research Coordinator, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri.; Clinical Pharmacist, Missouri Department of Mental Health, Center for Behavioral Medicine, Kansas City, Missouri.; Professor, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri.; Clinical Pharmacist, Missouri Department of Mental Health, Center for Behavioral Medicine, Kansas City, Missouri.; Director of Pharmacy, Missouri Department of Mental Health, Center for Behavioral Medicine, Kansas City, Missouri.; Psychiatrist, Missouri Department of Mental Health, Center for Behavioral Medicine, Kansas City, Missouri.; Associate Dean of the UMKC School of Pharmacy MU Campus and Professor, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri., Kriz CR; Clinical Research Coordinator, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri., Diefenderfer LA; Clinical Pharmacist, Missouri Department of Mental Health, Center for Behavioral Medicine, Kansas City, Missouri., Nelson LA; Professor, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri., Lang SE; Clinical Pharmacist, Missouri Department of Mental Health, Center for Behavioral Medicine, Kansas City, Missouri., Elliott ESR; Director of Pharmacy, Missouri Department of Mental Health, Center for Behavioral Medicine, Kansas City, Missouri., Moon J; Psychiatrist, Missouri Department of Mental Health, Center for Behavioral Medicine, Kansas City, Missouri., Sommi RW; Associate Dean of the UMKC School of Pharmacy MU Campus and Professor, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri.
Jazyk:	angličtina
Zdroj:	The mental health clinician [Ment Health Clin] 2022 Jun 10; Vol. 12 (3), pp. 175-180. Date of Electronic Publication: 2022 Jun 10 (Print Publication: 2022).
DOI:	10.9740/mhc.2022.06.175
Abstrakt:	Introduction: A defendant who is deemed incompetent to stand trial may go through competency restoration consisting of mental health treatment and legal education. Antipsychotics are often used in treatment; however, there is little data examining their role. Methods: This retrospective study included subjects opined competent to stand trial from July 2016 to February 2020 and prescribed an antipsychotic. The primary outcome was difference in time to competency between antipsychotics. Secondary outcomes included difference in time to competency between groups of antipsychotics, difference in length of stay after opined competent based on medication availability in jail, individual antipsychotics, and formulations. Results: There were 117 subjects included for analysis. There were no differences in time to competency between individual antipsychotics, first- and second-generation antipsychotics, or formulations. Length of stay after opined competent was significantly longer for subjects who were prescribed a long-acting injectable antipsychotic (103 days vs 56 days), who were not able to receive their antipsychotic in jail (104 days vs 54 days), or who were prescribed any formulation of paliperidone compared with olanzapine (88 days vs 35 days). Discussion: Since there were no differences in time to competency, patient-specific factors should be used to choose an agent for competency restoration. Length of stay differences are likely related to the antipsychotic access differences between jails and state psychiatric facilities. Therefore, policies related to antipsychotic access should better align between state psychiatric facilities and jails to improve the capacity of the system and provide better care. Competing Interests: Disclosures: The authors do not have a financial interest/arrangement or affiliation with 1 or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this study. (© 2022 AAPP. The Mental Health Clinician is a publication of the American Association of Psychiatric Pharmacists.)
Databáze:	MEDLINE
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