Forty-Two Percent of Patients Undergoing Arthroscopic Shoulder Surgery Are Using Psychotropic Medications

To determine the prevalence of psychotropic medication use in patients undergoing shoulder arthroscopy at a single institution and to identify the most common medications and classes of drugs being taken in this specific patient population.

We conducted a retrospective chart review of patients treated by 3 fellowship-trained orthopaedic sports medicine and shoulder surgeons between 2019 and 2021. All patients who underwent shoulder arthroscopy during this period were included. The following data were collected: age, sex, laterality of surgery, prior surgical procedures on the operated shoulder, specific surgery performed, and use of psychotropic medications. Drug categories included anticonvulsants, antidepressants/anxiolytics, sedative hypnotics, stimulants, antipsychotics, and multiple psychotropic drugs. Psychotropic medications were included if they were listed as being taken at any time in the patient's chart ("taking") within a 6-month window prior to surgery.

Of the 1,279 patients (828 male and 451 female patients) whose charts were reviewed, 534 (41.8%) were prescribed at least 1 psychotropic. Of the 453 patients treated in 2021, 201 (44.4%) were taking at least 1 psychotropic. Similarly, 152 of the 397 patients treated in 2020 (38.2%) and 181 of the 429 patients treated in 2019 (42.2%) were found to be taking at least 1 psychotropic. Among the 1,279 patients included, 282 of 828 male patients (34.1%) were prescribed psychotropic drugs compared with 252 of 451 female patients (55.9%, P = .001). From 2019 to 2021, 137 of the patients using psychotropic drugs (25%) were prescribed anticonvulsants/mood stabilizers; 105 (19%), antidepressants; 75 (14%), sedative hypnotics; 23 (4%), stimulants; 4 (1%), antipsychotics; and 190 (35%), multiple psychotropics. From 2019 to 2021, the rate of antidepressant/anxiolytic and/or sedative hypnotic prescription psychotropic drug use increased from 28% to 30.5% (P = .42).

This study showed that a large portion of patients undergoing shoulder arthroscopy were taking psychotropic medications. Furthermore, we found that female patients had significantly higher utilization of these medications compared with male patients.

Understanding the prevalence of these medications in orthopaedic patients is essential for surgeons to take into consideration to limit preoperative, intraoperative, and postoperative complications, as well as optimize patient outcomes.