Antipsychotic Polypharmacy and High Doses in a Rural Portuguese Community Mental Health Service

• Main Authors: Sara Ramos, Diana Cruz, Bianca Jesus, João Correia, Isabel Vaz, João Mendes
• Format: Article
• Language: English
• Published: Sociedade Portuguesa de Psiquiatria e Saúde Mental 2021-09-01
• Series: Revista Portuguesa de Psiquiatria e Saúde Mental
• Subjects: Antipsychotic Agents; Community Mental Health Centers; Inappropriate Prescribing; Polypharmacy
• Online Access: https://www.revistapsiquiatria.pt/index.php/sppsm/article/view/163
• ISSN: 2184-5522; 2184-5417

Introduction: Antipsychotic polypharmacy (APP) and high dose (APHD) remain a common practice in the treatment of severe mental illness, even though they are not supported by current international guidelines. Methods: We aimed to establish the prescribing patterns of antipsychotics in a community mental health service in a rural setting, to determine the prevalence of APP and APHD treatment and to identify associated factors. Results: We identified 284 patients. APP was present in 46.5% patients and was associated to younger age, single status, more previous psychiatric admissions, and anticholinergic prescription. Prescription of APHD was observed in 14.4% patients and was associated with previous inpatient admissions, being prescribed with a first generation long‑acting injectable antipsychotic and anticholinergics. We also found that APP and APHD were mutually associated. Conclusion: Despite current guidelines, we found prevalences of APP and APHD of 46.5% and 14.4%, respectively. Further studies are necessary to better evaluate the antipsychotic prescription patterns in Portugal.