Evidence map›Paper›PMID 40329432›Full record

ArticleSchizophrenia bulletin2026

Trends in Antipsychotic Polypharmacy and Potential Overtreatment with Antipsychotics: A Naturalistic Cohort Study of People in Long-term Care.

Stijn Crutzen, Shiral Gangadin, Ken Ho Hua, Ellen Visser, Frederike Jörg, Lisette van der Meer, Gerdina Hendrika Maria Pijnenborg, Wim Veling, Stynke Castelein

Abstract read
In one paragraph

Article in Schizophrenia bulletin, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Stijn CrutzenRob Giel Research Center, University Center Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.ORCID 0000-0002-0537-0858
Shiral GangadinRob Giel Research Center, University Center Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.ORCID 0000-0002-0084-8226
Ken Ho HuaApotheek Spaarne Gasthuis, Spaarne Gasthuis, Haarlem/Hoofddorp, The Netherlands.
Ellen VisserRob Giel Research Center, University Center Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Frederike JörgRob Giel Research Center, University Center Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Lisette van der MeerDepartment of Clinical & Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands.
Gerdina Hendrika Maria PijnenborgFaculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
Wim VelingPsychosis Department, University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Stynke CasteleinLentis Research, Lentis Psychiatric Institute, Groningen, The Netherlands.ORCID 0000-0002-8419-568X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDue to the side effects of antipsychotics, overtreatment is an important concern. Previous research focused on antipsychotic polypharmacy and excessively high doses. In this study, the aim is to map changes over the years in potential overtreatment, antipsychotic polypharmacy, total antipsychotic dose, and subjective side effect burden. Moreover, the association of the total dose and antipsychotic polypharmacy with the subjective side effect burden will be investigated. STUDY

designData from a naturalistic longitudinal cohort were used (PHAMOUS, 2013-2021). Potential overtreatment was defined as a antipsychotic dose equivalent to > 5 mg risperidone or antipsychotic polypharmacy, in combination with a high subjective side effect burden. Mixed effect models were used to investigate trends in potential overtreatment, antipsychotic polypharmacy, total antipsychotic dose, and subjective side effect burden and to assess the association of total dose and antipsychotic polypharmacy with subjective side effect burden. STUDY

resultsOverall, 15,717 observations nested in 5,107 participants were used. One-third of the participants were potentially overtreated, which did not change over time. The prevalence of a dose above the equivalent of 5 mg risperidone decreased, antipsychotic polypharmacy prevalence increased, and the subjective side effect burden decreased. A higher dose and antipsychotic polypharmacy were associated with higher subjective side effect burden.

conclusionPotentially overtreated patients should be revaluated to assess whether changes are needed. To assess whether a patient is truly overtreated, their clinical history, number of relapses, patients' preferences, overall functioning, previous attempts to reduce antipsychotic treatment, and previous severity of disease should be taken into account.

Indexed as

Antipsychotic AgentsLong-Term CareMedical OverusePolypharmacyAdultAgedCohort StudiesFemaleHumansLongitudinal StudiesMaleMiddle AgedSwedenAntipsychotic Agentsdeprescribingpsychosisside effects

Identifiers

PMID40329432
PMCPMC12809800

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.