<p>Psychotropic medications for treating schizophrenia and schizoaffective disorders are associated with adverse effects that require medication. Strategies to reduce these additional medications need exploration as they could impact treatment costs and the patient’s recovery experience. The study was a retrospective case-file audit of psychotropic medications and medication treatments for metabolic and non-metabolic physical conditions (MPCs) known to be associated with psychotropic drugs in 239 patients with enduring schizophrenia and schizoaffective disorders discharged from a long-stay inpatient rehabilitation unit. Nearly 90% of patients were prescribed MPCs, averaging 3.2 daily medications. Lipid abnormalities and constipation accounted for 42.3% of the MPC prescriptions. The most frequently prescribed psychotropic drugs were clozapine and mood stabilisers. The number of MPCs for non-metabolic conditions was significantly higher with clozapine prescription and lower with the use of olanzapine or an FGA (haloperidol, chlorpromazine, flupenthixol, zuclopenthixol). Clozapine was associated with fewer MPCs when combined with other antipsychotics. The MPC number did not correlate with patient age, number of antipsychotics or non-antipsychotic psychotropics, but correlated positively with hospitalisation duration. MPCs were frequently prescribed for patients in a long-stay inpatient psychiatric rehabilitation setting. The use of MPCs for non-metabolic conditions, but not metabolic conditions, varied with different psychotropic medications and with hospitalisation duration. Combining clozapine with another antipsychotic, prescribing olanzapine, or an FGA are three possible strategies for reducing MPC use in a cohort with enduring and treatment-resistant schizophrenia and schizoaffective disorders.</p>