A minority of patients, ranging from 18 to 36% in recent studies, are prescribed four or more psychotropic medications (Bauer et al. 2013a; Weinstock et al. 2014; Golden et al. 2017; Goldberg et al. 2009).
In a recent report from the STEP BD project, Goldberg et al. (2009) found that 67% of bipolar subjects were on two or more psychotropics, 40% of subjects received three or more psychotropic medications, while 18% of patients were taking four or more.
These findings suggest that: (1) BPD patients will probably be prescribed more psychotropic medications than other psychiatric outpatients, and (2) in addition to psychotropic medication prescription, there may be additional variables (e.g., psychotherapy sessions) that make a meaningful contribution to the overall healthcare utilization among those with BPD.
Compared to those with other types of personality disorders (n = 128) or no personality disorder at all (n = 91), those with BPD (n = 61) were diagnosed with significantly more axis I disorders, prescribed significantly more psychotropic medications, and attended significantly more psychotherapy sessions.
Polypharmacy, defined as two or more psychotropic medications, is prescribed to the majority of inpatients and outpatients, including the elderly (Weinstock et al. 2014; Bjørklund et al. 2016; Bauer et al. 2013a; Peselow et al. 2016; Kleimann et al. 2016; Golden et al. 2017; Rej et al. 2017; Kessing et al. 2016).
bCombination of 2 or more psychotropic medications.
Nine children in the SPD group were taking one or more psychotropic medications (8× risperidone, 3× fluoxetine, and 1× imipramine), and two were taking sodium valproate.
Forty-four per cent, 16.5% and 11.3% of women in the exposed group reported the use of two, three and four or more psychotropic medications, respectively.
22 Smits et al 23 found that persistent FAs, compared with those who were FAs at only one time point, experienced more social problems, psychiatric problems (and received more prescriptions for psychotropic medication) and medically unexplained physical symptoms, in addition to more chronic disorders (especially diabetes).
