Background

• Current guidelines suggest reserving combination antipsychotic therapy (CAT) as a fourth- or fifth-line option in cases of resistance
• Previous studies investigating CAT have found an increase in movement-related adverse effects, although not significant, as well as predicted reduced survival rate while little significant clinical benefit has been seen
• There is limited prior evidence investigating risks of CAT in the forensic population
• Few previous studies have investigated patient outcomes in a pre-post design to mitigate limitations of varying severities of illness

Primary Outcome

• Compare frequency of adverse drug reactions (ADRs) in patients before and after initiation of combination
  antipsychotic therapy

Secondary Outcomes

• Evaluate frequency of medication use for extrapyramidal symptoms (EPS), hyperlipidemia (HLD), or diabetes in patients before and after initiation of multiple antipsychotics
• Assess changes in lipid profiles, A1C, complete blood count (CBC), and BMI
• Compare frequency of ADRs for each combination regimen

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