Monotherapy Ot Polypharmacy ? Prevalent Prescription Patterns in a Big General Hospital

Abstract

Introduction In general, monotherapy is advocated. However, a proportion of the treatment regimens contains two or more drugs from the same class (i.e. polypharmacy) or a combination of drugs from different classes. Objectives To investigate the prevalence of prescription patterns of psychotropic drugs to our outpatients with schizophrenia, unipolar depression or bipolar disorder. Methods Files of 510 outpatients were studied. A retrograde examination was done spanning for 6 months. Demographics, details of diagnosis, hospitalizations and a chart of the drugs administered were collected. A comparison was done between various characteristics of patients under polypharmacy and monotherapy. Results Polypharmacy as well as combination therapy was more prevalent than monotherapy in all groups. Patients with a history of previous hospitalizations were not prone to be under polypharmacy, excluding depressives . Antidepressant prescription in schizophrenics was unusually high reflecting the easiness of use of new agents for negative symptomatology . The most commonly prescribed antipsychotics were quetiapine, olanzapine and risperidone. Classical antipsychotics had medium proportion of the treatment, mainly as combined therapy. Mirtazapine, Venlafaxine and Sertraline were the most commonly prescribed antidepressants Tricyclics were prescribed also Conclusions .. Greek clinicians' attitude for polypharmacy, regardless of the diagnosis, is prevalent. The recent changes in reimbursement policies of the healthcare System in Greece, did little to affect antipsychotics, but had an effect in the prescribing patterns of antidepressants