Editor’s Choice – Psychiatric Polypharmacy, Etiology and Potential Consequences – Current Psychopharmacology

Journal: Current Psychopharmacology

Author(s): Sonali Sarkar.

Graphical Abstract:

 

Abstract:

Psychiatric polypharmacy is defined as the use of two or more drugs in the treatment of a psychiatric condition. It is widely prevalent in clinical practice. The rationale for polypharmacy is not clear. Etiologic factors are patient demographics (age, gender, race, low socioeconomic status), personality disorder, 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 sideeffects. 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, concurrently having dual diagnosis with substance abuse, personality disorder and certain medical 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. Here we review the problem of polypharmacy in psychiatric patients, describe possible etiologic factors, associated consequences and provide recommendations for promoting beneficial polypharmacy and reducing harmful polypharmacy in clinical practice.

Press Release for EurekAlert! Polypharmacy in psychiatric practice, etiology and potential consequences

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.

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

For more information about the article, please visit: http://benthamscience.com/journals/current-psychopharmacology/article/145585/

World Trauma Day!

world-trauma-day-17-oct

Today, on the 17th of October 2016, we raise awareness about the Trauma and related disorders and their possible treatments. Bentham Science Publishers has various research journals dedicated to the Trauma and related disorders. The most significant are;

http://benthamscience.com/journals/adolescent-psychiatry/

http://benthamscience.com/journals/current-psychiatry-reviews/

Highlighted Article Flyer for the journal “Current Psychiatry Reviews”

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http://benthamscience.com/journals/current-psychiatry-reviews/

Essential Journals on Psychiatry Research

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Click on the journal to access the complete list of articles:

Adolescent Psychiatry
Current Psychiatry Reviews

Browse journals by subject here: http://bit.ly/1oNS4Sa

 

Bentham Open Access Article – Current Psychiatry Reviews

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The article, “Collecting Information for Rating Global Assessment of Functioning (GAF): Sources of Information and Methods for Information Collection” in the journal Current Psychiatry Reviews, 2014, 10, 330-347 is now open for all to view and access

For article Information, please visit: http://bit.ly/1IWhdAU

For journal information, please visit: http://bit.ly/1IWgUpG

 

Adolescent Psychiatry Volume 4, Number 3, 2014 – Content

9-11-2014 4-03-20 PM

For any information, visit: http://benthamscience.com/journal/index.php?journalID=aps

An Alarming News: 6% of Adolescents use Psychotropic Drugs

Psychotropic drugs are medicines which means a particular chemical material that affects primarily upon the nervous system. It indirectly affects brain function, which results in changes in mood, perception, understanding and behavior. It was reported that six percent of adolescents aged 12-19 years self-reported that they had taken a psychotropic medication in the past month, but only half had seen a mental health professional in the last year. Drugs like anti-depressants and medicine related to ADHD are used frequently by the adolescents. The negative effects of these medicines can be seen on the normal children. They start misbehaving, having mood swings and many other variants. An adolescent has to go through a difficult phase in his life, these medicines are thought of as saviors but are not. Lack of awareness and social pressure, these components can force the young-adult to take the medicine without a prescription. Psychotropic drugs are detrimental to the health. Guardians and parents should keep a look out for their loved ones and stop them from this abuse.

[News borrowed from: http://www.clinicalpsychiatrynews.com/]

Bentham Science Publishers has a subscription based journal “Current Psychiatry Reviews”, it publishes frontier review articles and guest edited issues dedicated to clinical research on all the latest advances on clinical psychiatry. The journal is indexed by hemical Abstracts, Scopus, EMBASE, EMNursing, PsycINFO, Genamics JournalSeek, MediaFinder®-Standard Periodical Directory, PubsHub, J-Gate.

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