Correlates of Psychotropic Polypharmacy in outpatient psychiatric clinics of two military tertiary hospitals in Saudi Arabia

Alharbi, Fares; Alharbi, Samar F; Salih, S Bin; Al-Surimi, Khaled

doi:10.4103/jfcm.jfcm_31_19

Cited by 3 publications

(6 citation statements)

References 37 publications

(49 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A Swedish study of adults aged 75 years and older found that the rate of concomitant prescription of two or more benzodiazepines or benzodiazepine-related medications (including hypnotics and anxiolytics) was 4.7%, with older age, female sex, urban setting, number of prescribed non-psychiatric medications, antidepressant use, and antipsychotic use being associated with polypharmacy ( 25 ). A study of patients attending outpatient psychiatric clinics in Saudi Arabia that defined psychotropic polypharmacy as the prescription of two or more psychotropic medications reported a prevalence of psychotropic polypharmacy of 46.9%, with older age, divorce, and diagnoses of psychosis and bipolar disorder associated with psychotropic polypharmacy ( 22 ). A study on bipolar disorder in Europe that defined psychotropic polypharmacy as the prescription of four or more psychotropic medications reported that the prevalence of psychotropic polypharmacy was 40.5%, and single status, older age, number of hospitalizations, and presence of psychiatric comorbidities were associated with polypharmacy ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

“…It is understandable that older patients are less likely to be prescribed benzodiazepine anxiolytic polypharmacy, as they are generally more susceptible to side effects than younger patients ( 36 ). No studies have examined the association between sex or occupation and benzodiazepine anxiolytic polypharmacy, and the results of previous studies examining the factors associated with psychotropic medication polypharmacy are inconsistent ( 22 , 27 , 37 ). Since this study lacks information on marital status, cohabitants, and income, which have been examined in previous studies, future studies with sophisticated designs are needed to clarify the association between benzodiazepine anxiolytic polypharmacy and sociodemographic factors.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have examined psychotropic polypharmacy using various definitions (e.g., concomitant use of psychotropic medications of the same or different classes) in various populations (e.g., the elderly, children, adolescents, patients with bipolar disorders, and patients with mental retardation) ( 22 – 25 , 38 ). Previous studies have shown that psychotropic polypharmacy is associated not only with age, sex, and concomitant psychotropic medications but also with numerous other factors not considered in this study, including marital status, comorbid psychiatric disorders, and the number of non-psychotropic medications prescribed ( 22 – 25 ).…”

Section: Discussionmentioning

confidence: 99%

“…Benzodiazepine hypnotics are generally used to treat insomnia, whereas benzodiazepine anxiolytics are used to treat anxiety, agitation, and aggression associated with psychiatric disorders. While some studies have examined the factors associated with psychotropic polypharmacy ( 22 – 24 ) and benzodiazepine sedative-anxiolytics ( 25 ), to our knowledge, no study has examined the factors associated with polypharmacy limited to benzodiazepine anxiolytics or benzodiazepine hypnotics. Therefore, an approach that distinguishes between benzodiazepine anxiolytics and hypnotics and examines the factors associated with each type of polypharmacy may be useful.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Association between benzodiazepine anxiolytic polypharmacy and concomitant psychotropic medications in Japan: a retrospective cross-sectional study

Takeshima,

Yoshizawa,

Ogasawara

et al. 2024

Front. Psychiatry

View full text Add to dashboard Cite

IntroductionGuidelines for various psychiatric disorders recommend short-term use of benzodiazepine anxiolytic monotherapy in few cases. Contrarily, benzodiazepine anxiolytic polypharmacy (BAP) is not recommended in any case. However, BAP is often used in real world. Therefore, this study aimed to determine the association between BAP and concomitant use of psychotropic medications.MethodThis retrospective cross-sectional study used claims data from the Japan Medical Data Center. Medical information of health insurance subscribers treated with benzodiazepine anxiolytics in June 2019 was extracted. Prescription of two or more benzodiazepine anxiolytics was defined as BAP. Binary logistic regression analysis was performed to investigate the factors associated with BAP, using age group, sex, type of subscriber, and number of concomitant hypnotics, antidepressants, and antipsychotics (none, one, and two or more) as covariates.ResultThe eligible participants were 104,796 adults who were prescribed benzodiazepine anxiolytics. Among them, 12.6% were prescribed two or more drugs. Logistic regression analysis revealed that BAP was significantly associated with those who received hypnotic monotherapy (adjusted odds ratio [aOR]: 1.04, 95% confidence interval [CI]: 1.001–1.09, p=0.04), antidepressant monotherapy and polypharmacy (aOR: 1.57, 95% CI: 1.51–1.63, p<0.001 and aOR: 1.98, 95% CI: 1.88–2.09, p<0.001, respectively), and antipsychotic monotherapy and polypharmacy (aOR: 1.12, 95% CI: 1.07–1.19, p<0.001 and aOR: 1.41, 95% CI: 1.30–1.54, p<0.001, respectively). Conversely, lower BAP was associated with those who received hypnotic polypharmacy (aOR: 0.86, 95% CI: 0.81–0.91, p<0.001).DiscussionThis study showed that the greater the number of concomitant antidepressants and antipsychotics, the greater the association with BAP. Since combination therapy with antidepressants or antipsychotics is generally not recommended, patients receiving combination therapy with these medications may be resistant to pharmacotherapy. Therefore, implementing the recommended non-pharmacological treatments may reduce BAP.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Association between benzodiazepine anxiolytic polypharmacy and concomitant psychotropic medications in Japan: a retrospective cross-sectional study

Takeshima,

Yoshizawa,

Ogasawara

et al. 2024

Front. Psychiatry

View full text Add to dashboard Cite

show abstract

“…The aims of this program include early detection of depression and anxiety among primary health centres’ outpatients, and provision of primary mental health services for prevention of chronic diseases ( 51 ). Previous Saudi reports also indicate that pharmacotherapy – specifically polypharmacy, i.e., use of multiple medication – is common among outpatients with medical conditions ( 52 ) and mental disorders ( 53 ). However it is unclear how effectively and explicitly comorbidities are targeted, or addressed in the healthcare sector, or across other sectors in the KSA generally.…”

Section: Discussionmentioning

confidence: 99%

Dual burden of chronic physical conditions and mental disorders: Findings from the Saudi National Mental Health Survey

Altwaijri,

Al-Habeeb,

Al-Subaie

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

IntroductionComorbidities of mental disorders and chronic physical conditions are a common medical burden reported among Western countries. National estimates of such comorbidities among the general population of Arab countries like Saudi Arabia are unknown. This study examined the prevalence of lifetime chronic physical conditions among the Saudi general population with DSM-IV 12-month mental disorders, and the associations with disability in the Kingdom of Saudi Arabia (KSA).MethodsThe Saudi National Mental Health Survey, a cross-sectional household study – part of the World Mental Health (WMH) Survey Consortium – was conducted between 2013–2016 in the KSA, with 4,001 Saudi citizens aged 15–65 (response rate 61%). The World Health Organization Composite International Diagnostic Interview 3.0 was used to assess prevalence of lifetime chronic physical conditions and 12-month mental disorders; disability was measured in terms of days out of role.ResultsThe prevalence of any comorbid 12-month mental disorder among those with chronic physical conditions was 24%. Major depressive disorder, social phobia, and adult separation anxiety disorder were the most common comorbid mental disorders across all chronic physical conditions. Gender, education, income, urbanicity, region, and employment were associated with the presence of any chronic physical condition. Respondents with mental / physical comorbidities had 2.97 days out of role (on average) in the last 30 days.ConclusionComorbidities of mental disorders and chronic physical conditions are common among Saudis. National efforts are needed to increase awareness of such comorbidities among the general population, and develop prevention and treatment services tailored to the needs of individuals at-risk for comorbidities.

show abstract

Factors associated with potential drug–drug interactions in psychiatric inpatients

2022

View full text Add to dashboard Cite

ObjectiveThe aim of this study was to investigate the prevalence and severity of potential drug–drug interactions (pDDIs) in hospitalised patients with major psychiatric disorders and to identify factors associated with their occurrence.MethodsThe research was designed as an observational, cross-sectional study conducted at the Clinic for Mental Disorders (CMD) ‘Dr. Laza Lazarevic’, Belgrade, Serbia. Medscape, Epocrates and Lexicomp bases were used to detect potential drug interactions among inpatients. Multivariate regression analysis was used to reveal risk and protective factors associated with the number of pDDIs.ResultsThe study included 511 patients, average age 44.63±11.81 years. The average number of pDDIs per patient ranged from 5.9±4.7 (Medscape) to 8.2±5.4 (Epocrates) and 8.5±5.1 (Lexicomp). The following risk factors were identified by all three interaction checkers used: C-reactive protein, number of pharmacological subgroups, number of prescribed drugs, antibiotics, antacids, vitamins, number of associated comorbidities, route, form and dose of the drug.ConclusionsWhen making clinical decisions to reduce drug problems, including DDIs, one should consult several interaction databases, which should be reviewed by a multidisciplinary team consisting of an experienced clinical pharmacist, physician, nurse, and so on.

show abstract

Correlates of Psychotropic Polypharmacy in outpatient psychiatric clinics of two military tertiary hospitals in Saudi Arabia

Cited by 3 publications

References 37 publications

Association between benzodiazepine anxiolytic polypharmacy and concomitant psychotropic medications in Japan: a retrospective cross-sectional study

Association between benzodiazepine anxiolytic polypharmacy and concomitant psychotropic medications in Japan: a retrospective cross-sectional study

Dual burden of chronic physical conditions and mental disorders: Findings from the Saudi National Mental Health Survey

Factors associated with potential drug–drug interactions in psychiatric inpatients

Contact Info

Product

Resources

About