Chronic Neuroleptic Exposure in Bipolar Outpatients

Background: Although the chronic use of neuroleptic medications is generally discouraged in patients with bipolar disorder, data on the actual extent of this practice are relatively scarce.

Method: All bipolar patients receiving treatment at the Connecticut Mental Health Center on September 1, 1994, were identified through a computerized administrative database; the medical record was then examined. Patients were included in the study if (1) the last two recorded diagnoses in the chart were concordant for bipolar disorder and (2) the patient had not been hospitalized in the past year.

Results: Of 49 patients meeting review criteria, 33 (67%) met criteria for chronic neuroleptic exposure. The mean±SD continuous neuroleptic dosage for these 33 outpatients was 416±527 mg/day chlorpromazine (CPZ) equivalents. The dosage distribution was skewed, with 17 (52%) receiving א200 mg/day CPZ equivalents.

Conclusion: Chronic neuroleptic administration occurred frequently in our sample of nonhospitalized bipolar outpatients.