Irish Journal of Medical Science, 2025 (SCI-Expanded, Scopus)
Background: Antipsychotics are the cornerstone of psychotic disorder treatment, often used in combination with other psychotropics. However, real-world data on inpatient treatment in Türkiye remain scarce. Aim: This study aims to investigate the clinical characteristics, hospitalization features, and psychotropic treatment patterns of inpatients diagnosed with psychotic disorders. Methods: This retrospective, cross-sectional pharmacoepidemiological study examined treatment patterns and predictors of antipsychotic polypharmacy (APP) among 934 patients (1241 hospitalizations) diagnosed with psychotic disorders at a university psychiatry clinic in Eastern Türkiye between 2001 and 2021. Results: The sample included 35.8% females and had a mean age of 34.03 ± 11.01 years. APP (use of ≥ 2 antipsychotics) was identified in 37.7% of cases, being significantly more frequent in males, those aged 55–65, schizophrenia (SCH) patients, and post-2012 hospitalizations. Atypical antipsychotics were prescribed in 95.25% of cases, and the most common APP pattern was atypical–atypical combinations (52.5%). Olanzapine (33.04%), risperidone (27.88%), and quetiapine (19.58%) were the most frequently prescribed agents. Mood stabilizers and antidepressants were used in 25.22% and 14.5% of cases, respectively. Multinomial regression showed that schizoaffective disorder (SAD) was strongly associated with both APP (OR = 3.05) and combined therapy (OR = 20.0), while delusional disorder also predicted combined therapy (OR = 2.4). Longer hospitalization duration and post-2012 admissions predicted APP, whereas outpatient follow-up and medical comorbidities predicted combined treatment. Linear regression revealed that higher PANSS scores predicted longer hospital stays, while hospitalizations in later years were associated with shorter stays. Conclusions: This study provides one of the most comprehensive longitudinal evaluations of inpatient psychosis treatment in Türkiye and offers valuable insights into prescribing trends, informing future clinical and policy approaches.