Psychopharmacology & polypharmacy

Yalçın N.

11th International Congress on Psychopharmacology & 7th International Symposium on Child and Adolescent Psychopharmacology, Antalya, Turkey, 18 - 21 April 2019, vol.29, no.1, pp.411-412

  • Publication Type: Conference Paper / Summary Text
  • Volume: 29
  • Doi Number: 10.1080/24750573.2019.1606883
  • City: Antalya
  • Country: Turkey
  • Page Numbers: pp.411-412
  • Hacettepe University Affiliated: Yes


Despite that clinical guidelines recommend monotherapy as the preferred therapy for the treatment of pediatric psychiatric disorders, the use of psychotropic polypharmacy (≥2 medications) is quite common in clinical practice [1]. Overall the prevalence of psychotropic polypharmacy ranges from 14% to 73% among pediatric population [2]. It is important to clearly define the current terms used for simultaneous psychotropic prescription. Copharmacy, describes the pharmacologic treatment of different disorders with two or more medications. Concomitant psychotropic medication, is the use of two or more medications for either the same or different psychiatric symptoms or disorders [3]. In this context, the risk of drug-drug interaction is increased in the presence of both kinds of polypharmacy. Therefore, in this study, psychotropic drug-related problems (polypharmacy, drug-drug interactions, off-label psychotropic drug usage) in pediatric inpatients were evaluated in a university hospital by the child and adolescent psychiatrists and clinical pharmacists. This retrospective study included 200 inpatients who were consulted to the Child and Adolescent Psychiatry clinic and that received psychotropic medication between January 2016 and September 2017. The mean age (standard deviation) was 11.88 (4.13) years and 5.41 (3.52) months. Of the patients, 118 (59%) were female, 4 (2%) were smoker, 4 (2%) were alcohol consumer and 2 (1%) were substance abuser. Sixteen patients (8%) had a psychiatric family history, 13 (6.5%) were exitus. While the average total number of psychiatric drugs they used during hospitalization was 1.29 (0.55), the total number of drugs was 7.39 (4.45). The majority of patients were in general pediatric service (61; 30.5%), intensive care unit (30; 15%) and hematology unit (20; 10%). The most commonly used psychotropic drug was escitalopram (69; 26.74%). 49 (24.5%) patients prescribed concomitantly 2 or more psychotropic drugs during hospitalization. A total of 336 drug interactions were observed (1.68 interactions / patients). Of these, 53 (15.77%) were between two psychotropic drugs. At the same time, there was a significant correlation between the number of psychiatric drugs and total number of drug-drug interactions (r: 0.680, p < 0.01). These results suggest that as the psychiatric polypharmacy increases, the potential drug-drug interactions that can cause harm to the patients are increasing. Considering the increased risk of drug-drug interactions, side effects, and drug noncompliance with the increased polypharmacy, it is thought that simplification of drug therapy can be beneficial in pediatric inpatients.