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Activity Dates: 06/12/2014 - 04/27/2017

This course is closed. Please look for other available products in CPNP University.

Target Audience

This course is designed for pharmacists, nurse practitioners or other healthcare professionals involved in the comprehensive medication management of psychiatric and/or neurological patients.

Session Summary

Polypharmacy with psychiatric drugs is common. Combinations of antipsychotic drugs upon hospital discharge have come under scrutiny by The Joint Commission. The evidence base for the use of combined antipsychotic medications and combined antidepressant medications is limited. Available evidence will be presented and evaluated in order to identify situations where combination therapy may be rationally applied to patient care. Hospital-Based Inpatient Psychiatric Service (HBIPS) measures regarding antipsychotic polypharmacy will be described and potential roles for pharmacists in complying with these measures will be discussed. The potential risks of antipsychotic polypharmacy have been identified and include increased risk of endocrinologic disturbances such as hyperprolactinemia as well as a possible increase in all-cause mortality associated with combinations of antipsychotics. Evidence supporting combination therapy with antipsychotic medications is minimal, although there may be a role for some combinations including clozapine. Antidepressant polypharmacy, despite theoretical justification based on hypothesized mechanisms of action of various antidepressants, has not been demonstrated to be of benefit, although most trials have been small and uncontrolled. While initial studies appeared to identify a potential advantage to initiation of treatment with combined antidepressants, this was not confirmed in more extensive studies (CO-MED). There is a potential for genetic phenotyping to assist in optimization of monotherapy as well as to explain apparent successes with polypharmacy that are actually related to drug-drug interaction at metabolizing enzymes.


Course Requirements

You will proceed through the following steps to satisfactorily complete this course:

  • Review the full content of the activity and reflect upon its teachings.
  • Complete the post-test at the end of the activity no later than the closing activity date. (login first)
  • Complete the evaluation at the end of the activity. (login first)
  • If necessary, complete the post-test retest no later than the closing activity date. (login first)
  • Receive a passing grade (70%).
  • Provide the necessary details in your profile to ensure correct reporting by CPNP to CPE Monitor. (login first)

This course is provided online at cpnp.org and consists of the speaker audio and slides. A PDF file of the slides is also provided and access is available to participants indefinitely although ACPE credit is available only through the course expiration date.

Participants in this course must complete an examination and achieve a score of 70% or greater. Successful completion of the course also requires the completion of a course evaluation. ACPE statements of credit can be retrieved by participants online at cpnp.org immediately upon successful completion of the course.

Faculty Information and Disclosures

Learning Objectives

  1. Evaluate evidence-based literature regarding rational and irrational polypharmacy in psychiatric disorders.
  2. Describe the role of the Hospital-Based Inpatient Psychiatric Service (HBIPS) measures with regard to polypharmacy in the inpatient setting.
  3. Assess the benefits and potential toxicities associated with polypharmacy in patients with psychiatric disorders.
  4. Differentiate among the terms “rational polypharmacy”, “irrational polypharmacy”, and “augmentation therapy” for treatment of psychiatric disorders.

Continuing Education Credit and Disclosures

Activity Dates: 06/12/2014 - 04/27/2017
ACPE Contact Hours: 1.0
ACPE Number: 0284-0000-14-007-H01-P (Application)
Nursing Credit Reminder: Note that ACPE credit is accepted for certification renewal.

ACPEThe College of Psychiatric and Neurologic Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This course provides 1.0 contact hours (0.10 CEUs) of application-based continuing education credit. The ACPE universal program number assigned to this course is 0284-0000-14-007-H01-P (1.0 contact hours).

Grant Support

This activity is supported by an educational grant from Sunovion Pharmaceuticals, Inc. and Lilly. For further information concerning Lilly grant funding visit www.lillygrantoffice.com.