Nav: Home

Polypharmacy in psychiatric practice, etiology and potential consequences

December 05, 2016

Psychiatric polypharmacy is defined as the use of two or more drugs in the treatment of a psychiatric condition. Although, a lack of consensus has been reported among researchers globally about the number of medications that would quantify polypharmacy, nevertheless, it is widely prevalent in clinical practice. The rationale for polypharmacy is not clear. Etiologic factors are patient demographics (age, gender, race, low socio-economic status), personality disorder (obsessive-compulsive, borderline), psychiatric conditions (psychosis, schizophrenia, affective or mood disorders), comorbidities, severity of disease, treatment- refractoriness, prescribing practice, inpatient or outpatient setting, concern for reduction of extra-pyramidal and other side effects. Psychiatric polypharmacy is seen not only in adults but also in youths. Among children and adolescents' the polypharmacy correlates are age (13 -15 years), male gender, caucasian race, low socio-economic status, medicaid or public insurance, disability, and foster care or child custody outside of biological family. Pediatric polypharmacy is also associated with a diagnosis of behavioral disorder, autism spectrum disorder, ADHD, conduct disorder/oppositional defiant disorder, personality disorder, violence, tics, psychosis, affective and mood disorder.

The concurrent administration of multiple drugs increases the risk of drug interactions and adverse effect including morbidity and mortality. Psychiatric polypharmacy is also associated with cumulative toxicity, poor medication adherence and treatment non-compliance. Thus, psychiatric polypharmacy poses a significant public health problem. However, not all polypharmacy is harmful. Polypharmacy is proven to be beneficial in patients with psychotic, mood or affective disorder having dual diagnosis with substance abuse, personality disorder (obsessive compulsive) and comorbid conditions including thyroid, pain or seizure disorder. Combination therapy with different class of drugs antidepressants or antipsychotics with different mechanism of action have beneficial therapeutic consequences. Therefore, a better understanding of physicians' rationale for polypharmacy, patient tolerability and effectiveness of prescribing strategy is needed to guide practitioners and to inform the development of evidence based treatment guidelines.
-end-
For more information about the article, please visit http://benthamscience.com/journals/current-psychopharmacology/article/145585/

Reference: Sarkar, S.; et al (2016). Polypharmacy in Psychiatric Practice, Etiology and Potential Consequences. Curr Psychopharmacol., DOI: 10.2174/2211556005666160916124719

Bentham Science Publishers

Related Psychosis Articles:

Targeted treatment for depression could benefit patients with psychosis
Patients with early onset psychosis may benefit from treatment for depression, including with anti-depressants alongside other medication, new research shows.
Pimavanserin reduced symptoms of dementia-related psychosis in phase 3 trial
New data presented at the Alzheimer's Association International Conference indicates that pimavanserin leads to a robust reduction in the severity of psychosis symptoms during the 12 week open-label phase of the study, regardless of the underlying dementia subtype or the severity of participants' dementia.
Young people with early psychosis may not require antipsychotic medications to recover
Researchers at Orygen have found that some young people with early stage first episode psychosis (FEP) can experience reduced symptoms and improve functioning without antipsychotic medication when they are provided with psychological interventions and comprehensive case management.
NMDA receptors may link psychosis and sleep deficits
Sofya Kulikova, a researcher at HSE University in Perm, is part of an international research team that has discovered potential mechanisms that explain the sleep spindle deficit in electroencephalograms (EEG) of people with schizophrenia.
Almost half of all postpartum psychosis are isolated cases
A new research result from iPSYCH shows that 40% of the women who suffer a psychosis after giving birth -- known as postpartum psychosis - do not subsequently become ill again.
Thirty risk factors found during and after pregnancy for children developing psychosis
More than 30 significant risk factors have been identified for the development of psychotic disorders in offspring in research led by the NIHR Maudsley BRC.
A new window into psychosis
A recent study in mice led a team of researchers in Japan to believe that psychosis may be caused by problems with specialized nerve cells deep within the brain, as well as a certain kind of learning behavior.
New insight into how cannabidiol takes effect in the brains of people with psychosis
Researchers from King's College London have shown that cannabidiol (CBD) alters the brain activity in people with psychosis during memory tasks, making it more similar to the activation seen in people without psychosis during the same tasks.
Study finds 'cluster of disadvantage' behind BAME psychosis rates
Excess psychosis diagnoses amongst black and South Asian men in deprived urban areas could reflect a cluster of disadvantage in specific places, rather than individual experiences of deprivation alone, a study led by Queen Mary University of London researchers concludes.
Distinct brain region alterations in youth with psychosis spectrum disorders
Psychotic spectrum (PS) disorders are characterized by abnormalities in beliefs, perceptions and behavior, but how these disorders manifest themselves in earlier development stages is largely unknown.
More Psychosis News and Psychosis Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: The Power Of Spaces
How do spaces shape the human experience? In what ways do our rooms, homes, and buildings give us meaning and purpose? This hour, TED speakers explore the power of the spaces we make and inhabit. Guests include architect Michael Murphy, musician David Byrne, artist Es Devlin, and architect Siamak Hariri.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at Radiolab.org/donate.     You can read The Transition Integrity Project's report here.