Psychiatric Polypharmacy Continues to Grow

By John Gever, Senior Editor, MedPage Today
Published: January 04, 2010
Reviewed by Zalman S. Agus, MD; Emeritus Professor  University of Pennsylvania School of Medicine and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

Psychiatrists who prescribe drugs for their patients today usually give more than one at a time, often with little scientific basis, researchers said.   About 60% of patients with psychiatrist office visits leading to a drug prescription received at least two medications in 2005-2006, according to government survey data analyzed by Ramin Mojtabai, MD, PhD, MPH, of Johns Hopkins University, and Mark Olfson, MD, MPH, of Columbia University.

That was up from about 43% in 1996-1997 (P<0.001), the researchers reported in the January Archives of General Psychiatry.  They also found that 33% of prescription-associated visits led to three or more medications in the latter period, compared with 17% nine years earlier (P<0.001). These multiple combinations sometimes involved drugs within the same class — two or more antidepressants for depressed patients, for example — but more often drugs of different classes. Gaining in popularity during the study period were combinations of antidepressants and antipsychotic drugs, with an adjusted odds ratio of 1.96 (P<0.001) for each year during the study period.

Overall, the percentage of psychiatrist office visits leading to one or more drug prescriptions increased from 73.1% in 1996-1997 to 86.2% in 2005-2006 (P<0.001), Mojtabai and Olfson found.

Primary source: Archives of General Psychiatry
Source reference: Mojtabai R, et al “National trends in psychotropic medication polypharmacy in office-based psychiatry” Arch Gen Psych

The article can be found at

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