Polypharmacy in Psychiatry: Three Case Studies and Methods for Prevention

Abstract

OBJECTIVE:

To illustrate problems of overprescribing in the elderly and to make practical suggestions for prevention of polypharmacy.

DESIGN:

Three cases of polypharmacy in psychiatric patients admitted to the hospital between January and March 1990 are described. Intervention to correct drug-related problems in these patients is described and methods of preventing polypharmacy are discussed.

SETTING:

Inpatient psychiatry service in a tertiary-care center.

PATIENTS:

Elderly psychiatry patients (n=3) taking an excessive number of medications. This polypharmacy was believed to contribute to decreased cognitive and/or physical function.

INTERVENTIONS:

Medication regimens were reviewed by the physician and pharmacist. Those considered unnecessary or believed to be adversely affecting the patient were discontinued.

RESULTS:

All patients were discharged on a reduced number of medications, with improvement in cognitive and/or physical function.

CONCLUSIONS:

Polypharmacy contributes to an increased incidence of adverse reactions in the elderly. Implementation of practical methods for reducing polypharmacy can lead to a reduction in the number of drug-related adverse effects and improved care of the elderly patient.