Forty-two Percent of Patients Undergoing Arthroscopic Shoulder Surgery are Using Psychotropic Medications

Abstract

PurposeThe purposes of this study were to determine the prevalence of psychotropic medication use in patients undergoing shoulder arthroscopy at a single institution, and to identify the most common medications and classes of drugs being taken in this specific patient population. We hypothesized a large portion of patients undergoing shoulder arthroscopy are concomitantly taking prescription psychotropic medications. MethodsA retrospective chart review was conducted on patients treated by three fellowship trained orthopaedic sports medicine and shoulder surgeons between 2019-2021. All patients who underwent shoulder arthroscopy during this time period were included. The following data was collected: age, sex, laterality for surgery, prior surgeries on operated shoulder, specific surgery performed, and use of psychotropic medications. Drug categories included anticonvulsants, antidepressant/ anxiolytics, sedative hypnotics, stimulants, antipsychotics, and multiple psychotropic drugs. Psychotropic medications were included if they were listed as ‘taking’ at any point in time in the patient’s chart within a 6-month window prior to surgery. ResultsOf the 1,279 (828 males; 451females) patient charts that were reviewed, 534 (41.8%) were prescribed at least one psychotropic. In 2021, 201 (44.4%) of the 453 patients were taking at least one psychotropic. Similarly in 2020, 152 (38.2% of the 453 patients) and 2019, 181 (42.2% of the 429 patients) were found to be on at least one psychotropic. Of the 1,279 patients included, 282 (34.1%) of 828 males were prescribed psychotropic drugs, as compared to 252 (55.9%) of 451 females (p=0.001). From 2019-2021, 137 (25%) of the patients using psychotropic drugs, were prescribed anticonvulsant/mood stabilizers, 105 (19%) antidepressants, 75 (14%) sedative hypnotics, 23 (4%) stimulants, 4 (1%) antipsychotics, 190 (35%) were prescribed multiple psychotropics. From 2019-2021 the rate of antidepressant/ anxiolytic and or sedative hypnotic prescription psychotropic drug use increased from 28% to 30.5% (p=.42). ConclusionThis study demonstrated that a large portion of patients undergoing shoulder arthroscopy were taking psychotropic medication. Further, it was found that female patients had significantly higher utilization of these medications, as compared to males. Clinical RelevanceUnderstanding the prevalence of these medications in orthopaedic patients is essential for surgeons to take into consideration, in order to limit pre-, intra-, and post-operative complications, as well as optimize patient outcomes.