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Psychotropic polypharmacy. An analysis of a large outpatient prescription database
In the study presented we used the pharmafakt® Database, a data set of the German Statutory Health Insurance (SHI) prescription sheets (covering approximately 25 million people).
Nearly 6% of the population received antipsychotic agents during the study period (2,5 years). Conventional antipsychotics were predominantly prescribed. The majority of prescriptions was issued by non-specialists. Antipsychotic polypharmacy and co-medication with other psychotropic substances were very frequent (up to 50%). Most of the patients received co-medication for cardiovascular or metabolic diseases.
The high prevalence of prescriptions for antipsychotics suggests a substantial use beyond the schizophrenic population. Research on the efficacy and side-effects of antipsychotics in off-label use is urgently required, since these account for the majority of antipsychotic prescriptions.
Further, the high percentage of patients who receive a combination of different antipsychotics or antipsychotics and further medication rises questions on the tolerability and safety of existing prescribing habits.