Abstract
Objective: To analyze patterns of pro re nata (PRN) medication utilization during the seven-day periods preceding and following aggressive incidents in a forensic setting, including both psychotropic and somatic agents, to identify trends in use surrounding aggression.
Methods: This was a retrospective chart review at a long-term state forensic psychiatric facility. Patients housed on units associated with the New Outlook Program (NOP) within a six-month period who received PRN medications were included.
Results: Out of 106 patients evaluated, 42 were included. The mean age for study participants was 37 years old, with 83% being male. Out of 322 aggressive incidents, the overall PRN utilization rate was higher than the baseline in 38.8% of events (N = 125). For the overall seven-day period preceding and following an aggressive incident, there was no significant difference between psychotropic and somatic PRNs (β = −0.16, p = 0.74), and neither type showed a meaningful deviation from baseline (Intercept = −0.25, p = 0.46). Additionally, there was no significant difference in PRN utilization when separately assessing the seven-day period preceding or following an aggressive incident.
Conclusion: No consistent group-level trends in PRN utilization were identified in relation to aggression. However, some patient-level variation was observed post-incident, suggesting individualized patterns compared to group-level trends. These findings support the clinical value of monitoring individuals’ PRN utilization patterns to inform treatment planning. Psychopharmacology Bulletin. 2026;56(1):92–97.
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