Patterns of Drug Prescription in a Psychiatric Outpa- tient Care Unit The Issue Of Polypharmacy

Background: In psychiatry, polypharmacy is more the rule than the exception. The present study investigates the frequency and type of polypharmacy in various diagnostic groups amongst patients of a psychiatric outpatient care unit. Methods: Patients’ medical records were used to collect data on the last psychopharmacological medication prescribed in 2005 for all patients at the outpatient care unit (N = 429). Results: Patients with an initial diagnosis of schizophrenic psychosis were most frequently treated, followed by patients with affective disorders. 57 % of the patients received at least one psychotropic drug. 20 % of the patients received monotherapy and 36 % combination therapy. Patients with a schizophrenic psychosis most frequently received a combination therapy, followed by patients with affective disorders. Atypical anti-psychotic drugs were most often prescribed. The anti-psychotic drugs held the greater importance in the combination therapy. Conclusions: The chronic and severely ill patients in our sample represent a high-risk population for whom a polypharmacy of psychotropic substances might be advisable. When polypharmacy becomes necessary, it should only be administered according to evidence-based data. Due to the widespread use of polypharmacy in psychiatric care units, we are in urgent need of controlled studies further investigating combinations of substances (German J Psychiatry 2008:11: 1-6).