Patterns of psychotropic drug: RESULTS(4)

Commonly used psychotropic drugs by diagnosis

A total of 57.1% of all prescriptions were for patients with no psychiatric diagnosis (see Table 1). There was no class of cheapest drugs con fined to any diag nos tic cate gory. How ever, pa tients with psychiatric diagnoses were prescribed more antidepressants, an timan ics and anti-Parkinsonian drugs. Ap proximately 51% of patients with only medical, nonpsychiatric diagnoses were prescribed antipsychotic drugs.

TABLE 1

Diagnosis and psychotropic drugs prescribed

DSMIII diagnosis AP (n=86) Number (%) of psychotropic drugs prescribed AD (n=37) AM (n=29) BZD Plus (n=182) APK (n=37) Total (n=371)
Anxiety disorder 0 0 0 1 (0.5) 0 1 (0.3)
Eating disorder 0 2 (5.4) 0 1 (0.5) 0 3 (0.8)
Mood disorder 21 (24.5) 23 (48.6) 16 (13.8) 29 (8.2) 8 (21.6) 97 (26.1)
Organic brain syndrome 5 (5.8) 0 1 (3.4) 4 (2.2) 1 (2.7) 11 (3.0)
Schizophrenia and paranoid disorder 15 (17.4) 1 (2.7) 4 (13.8) 14 (7.7) 10 (27.0) 44 (11.9)
Other psychiatric disorders 0 1 (2.7) 1 (3.4) 1 (0.5) 0 3 (0.8)
Medical disorders 44 (51.2) 9 (24.3) 7 (24.1) 129 (70.9) 17 (45.9) 206 (55.5)
No diagnoses 1 (12) 1 (2.7) 0 3 (1.6) 1 (2.7) 6 (1.6)
Total Щ 86 (23.2) Щ 37 (10.0) | 29 (7.8) 182 (49.1) | 37 (10.0) 371 (100)

AD Antidepressants; AM Antimanics; AP Antipsychotics; APK Anti-Parkinsonians; BZD Plus Benzodiazepines and hypnosedatives; DSMIII Diagnostic and Statistical Manual of Mental Disorders, 3rd edition

Multiple drug use (polytherapy)

The definition of polytherapy as the concurrent use of two or more psychotropic drugs is restrictive for psychiatry. Some diagnostic categories such as major depression with psychosis may require at least three drugs. In this study, polytherapy was defined as the concurrent use of three or more psychotropic drugs (see Table 2). The prevalence of two or more psychotropic drugs in the population was 19.9%; however, by the study definition of polytherapy the prevalence was 9.5%. Factors that predisposed to polytherapy were male sex (%2= 1.06. P<0.3), psychiatry ward (%2=243.8, P<0.0001), psychiatric diagnoses (%2=226.2, P<0.0001), hospital structure (%2=152, P<0.0005) and prolonged length of hospital stay (Student’s t test = -1.36, P<0.17).

TABLE 2

Polypharmacy

VariableTotal population Prevalenci >2 drugs19.9 e of polypharr >3 drugs9.5 nacy (%) >4 drugs2.6
Sex
Male 22.3 11.4 5.1
Female 18.1 8.1 6.9
Discipline
Psychiatry 85.2 63.9 18
Obstetrics/gynecol 4.8 0 0
ogy
Internal medicine 10.8 2.3 0.6
General surgery 19.2 0 0
Pediatrics 0 0 0
Hospital
Saskatoon City* 25.0 11.9 3.1
Royal University* 24.5 13.0 3.8
St Paul’s1 4.6 0 0
Diagnosis
Psychiatric 85.0 63.3 18.3
Nonpsychiatric 9.9 1.3 0.3

Hospital with a psychiatry ward;f Hospital without a psychiatry ward

PRN dosing

Twenty-nine per cent of the total prescriptions were for PRN dosing. There were more PRN prescriptions for women (30%) than for men (28.7%) (%2= 1.16, P<0.28). PRN dosing was prescribed more by OBGYN (46.4%), MED (43.0%), PED (40.0%) and SURG (31.3%) than PSYCH (16.1%) (%2=17.9, P<0.001). SPH prescribed more PRN dosing prescriptions than the two hospitals with psychiatry wards (%2=1.7, P<0.43). More PRN medications were prescribed to younger and older patients (age younger than 19 years and older than 60 years) than to those of age 20 to 59 years (%2=15.9, P<0.026).

The data on the dose, route of administration and reasons for prescription ofthe psychotropic drugs were not analyzed because they were scant and complex to interpret between the specialty wards.

This entry was posted in Psychotropic drug and tagged Drug use, Medical specialists, Prescription, Psychotropic drug.