Polypharmacy in psychiatry: three case studies and methods for prevention
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R B Stewart1, K C Yedinak, M R Ware
1Department of Pharmacy Practice, College of Pharmacy, University of Florida, Gainesville 32610.
Objective:
To illustrate problems of overprescribing in the elderly and to make practical suggestions for prevention of polypharmacy.
Design:
Three cases of polypharmacy in psychiatric patients admitted to the hospital between January and March 1990 are described. Intervention to correct drug-related problems in these patients is described and methods of preventing polypharmacy are discussed.
Setting:
Inpatient psychiatry service in a tertiary-care center.
Patients:
Elderly psychiatry patients (n = 3) taking an excessive number of medications. This polypharmacy was believed to contribute to decreased cognitive and/or physical function.
Interventions:
Medication regimens were reviewed by the physician and pharmacist. Those considered unnecessary or believed to be adversely affecting the patient were discontinued.
Results:
All patients were discharged on a reduced number of medications, with improvement in cognitive and/or physical function.
Conclusions:
Polypharmacy contributes to an increased incidence of adverse reactions in the elderly. Implementation of practical methods for reducing polypharmacy can lead to a reduction in the number of drug-related adverse effects and improved care of the elderly patient.