Objectives:Background and aims:
Polypharmacy in the treatment of severe mental illness (SMI) is controversial; with little evidence to support the efficacy of such
treatment. Nonetheless pragmatically polypharmacy is often used to treat SMI. Therefore this pilot study aimed to identify the prevalence
of total psychotropic polypharmacy as well as anti psychotic polypharmacy both during admission and upon discharge from an acute
mental health unit at a regional hospital in NSW, Australia.
Materials and methods:
The de-identified medical charts of 109 consecutive patients admitted to the Wollongong Hospital Adult Mental Health Unit were audited.
The age, gender, prescribed agents and dosages for all patients were recorded for two time points; admission and discharge.
The 109 patients had a mean age of 39 years of which 64 (58.8%) were male and 45 (41.2%) were female. The results of a paired
samples t-test indicted that there were was a significant difference between the mean number of psychotropic agents prescribed upon
admission and discharge [t(108)=7.78, p<0.001]. Table 1 summarises the distribution of psychotropic drug use and same class
The results of this pilot study indicate that there is a significant change in the mean number of psychotropic agents prescribed between
admission and discharge. Total psychotropic polypharmacy as well as antipsychotic polypharmacy was found to be highly prevalent
within the assessed mental health unit. Further the results also indicate that a proportion of the patients were exceeding the
recommended daily doses of their prescribed agents. Directions for future research will be discussed.