Community treatment orders (CTOs) mandate the outpatient treatment of mental disorders through medications and other services. Individuals issued CTOs commonly display complex and chronic presentations of mental disorders, and are largely managed by long acting injectable (LAI) antipsychotics. The routine use of antipsychotic polypharmacy and high-dose antipsychotics are discouraged, due to the risk of serious adverse events. While persistence with antipsychotic polypharmacy and high-dose antipsychotics has been studied in outpatient populations, no previous study has evaluated persistence when CTOs are renewed. The objectives of our study were to determine the prevalence of psychotropic drug-regimen changes between CTOs, and to evaluate persistence with antipsychotic polypharmacy and high-dose antipsychotics.