Analysis of Psychotropic Polypharmacy and Associated Factors in Antidepressant-Treated Patients With Depressive Disorder: A Population-Based Cohort Study Using Real World Data.

INTRODUCTION

Psychotropic polypharmacy typically refers to the prescription of more than one psychotropic medication to a patient. While polypharmacy can sometimes be clinically justified, it is widely recognized that multiple drug use and exposure can be problematic. The aim of this article is to analyze polypharmacy experienced by patients with depressive disorders, estimating its incidence during the first year after diagnosis and exploring the sociodemographic, clinical, and health-related lifestyle factors related to psychotropic polypharmacy.

METHODS

A retrospective population-based cohort study was conducted among adults (aged 18 and over) within the Canary Islands Health Service. The study analyzed routine health record data from patients diagnosed with depressive disorders who received antidepressant treatment between 2013 and 2022. Psychotropic polypharmacy refers to the concurrent use of two or more psychotropic medications by the same patient. To explore the relationship with sociodemographic, clinical, and lifestyle characteristics, multivariate logistic regression analyses were conducted.

RESULTS

The study included a total of 39,800 participants, with a polypharmacy incidence of 86.28%. Most patients (48.10%) received three or more medications (N = 19,145). Factors associated with polypharmacy included the 45-64 age group (OR: 1.21), previous depressive episodes (OR: 1.15), number of comorbidities (OR: 1.11), and male gender (OR: 0.83).

CONCLUSION

The results highlight the complexity of psychotropic polypharmacy, especially in patients with previous episodes and comorbidities. While the use of multiple medications may be necessary, it is critical to periodically review treatments to ensure their safety, especially in vulnerable populations. New prescription trends suggest a shift toward more rational approaches, although further research is required to support clinical guidelines.