Pharmacopsychiatry 2003; 36 - 104
DOI: 10.1055/s-2003-825355

Psychotropic polypharmacy. An analysis of a large outpatient prescription database

J Hamann 1, W Kissling 1, A Ruppert 2, K Pugner 2
  • 1Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum rechts der Isar, Technische Universität München
  • 2Global Epidemiology and Outcomes Research, Bristol-Myers Squibb Int. Corp., Waterloo

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.