Antipsychotic polypharmacy in a general hospital inpatient psychiatric unit

Abstract

IntroductionThe association of antipsychotics is common in clinical practice despite the lack of scientific evidence to support this practice. There are few data on these patterns of use in hospitals in Spain. However, such data are required for the development of indicators of quality of care. AimsTo collect information on prescription of antipsychotics in a psychiatric inpatient unit. MethodsWe performed a retrospective observational study of inpatients under treatment with antipsychotic drugs in 2006. ResultsWe reviewed 136 patients with a mean age of 38 years and a mean length of stay of 22 days. Antipsychotics were used primarily in schizophrenic disorder (44.9%). At admission, atypical antipsychotics (second or third generation) were the most frequently used drugs in monotherapy (41.2%), a combination of two or more antipsychotics was used in 43% of the patients and the use of additional medication (not antipsychotics) was very high (84.6%). At discharge, the results were similar, but a notable finding was the increase in the combination of an atypical antipsychotic with extended-release drugs (from 2% to 11%). ConclusionsThe use of atypical antipsychotics as the first therapeutic option is becoming established, confirming the phenomenon of polypharmacy in the treatment of psychoses. The study design did not allow directional relations to be established but some trends, such as the possibility that polypharmacy is more common in patients with schizophrenia and is associated with the use of depot antipsychotics, were confirmed.