Antipsychotics as Adjunct Therapy in Risk Reduction of Crisis Admission: An Analysis of Historical Patient Data Authors Slawomir Piela, Drexel University

Introduction: Antipsychotics are a broad class of medication used in the management of psychotic symptoms in various disorders. In recent years, they have been approved for use as adjunct therapy in patients with treatment resistant depression and bipolar disorder. An outcome of this therapy that has not been extensively investigated is the associated likelihood of crisis events that necessitate admission to an emergency department or crisis center. Methods: In this study, we reviewed historic patient data to determine the association of risk of crisis admission in patients prescribed antipsychotics as adjunct therapy in the context of treatment resistant depression or bipolar disorder. Results: We found that only one of five medications, cariprazine, had any associated significant reduction of risk compared to those without adjunct therapy. Three of the five medications investigated (aripiprazole, olanzapine, and quetiapine) had associated statistically significant increased risk of crisis admission in treatment resistant depression and bipolar disorder. Discussion: Results were broadly mixed and necessitate further investigation. We found that cariprazine had consistently lower odds ratios for crisis admission compared to other adjunct therapies in mood disorder groups. Further studies will need to investigate confounding factors such as other comorbid diagnoses and symptom severity.