Assesment of Antipsychotic Polypharmacy in Patients with Bipolar Affective Disorder in a Tertiary Care Hospital

Abstract

Bipolar affective disorder is a mental illness characterized by extreme mood swings accompanied by episodes of arousal or depressive emotions. Aim/Background: The main aim is to assess the antipsychotic polypharmacy in patients with bipolar disorder.

Result: Out of 68 patients studied, only 7 antipsychotics were prescribed, in which olanzapine was the most common (48.53%), among them (36.8%) antipsychotics polypharmacy. Among 25 patients, (27.9%) were given SGA +SGA combination. A total of 17 Adverse Drug Reactions were observed in which the most common was sleep disturbance (27.9%). Causality assessments showed that majority of Adverse Drug Reactions were categorized as probable (47.5%) and possible (46.25%) in nature by Naranjo’s Causality Assessment Scale. A total of 191 potential Drug-Drug Interactions were observed, the most prevalent type of interaction observed was moderate (86.9%), which was Lorazepam+Olanzapine (7.9%).

Conclusion: From the present study, it was concluded that among antipsychotics, ‘olanzapine’ (SGA) was the drug of choice for bipolar disorder. Considering older patients with bipolar disorder they have increased risk of drug induced adverse events, therefore the use of antipsychotics in this population needs careful consideration. In such cases antipsychotic polypharmacy may lead to better symptom relief and functional outcome with minimization of side effects associated with higher doses of single drug.

Key words: Polypharmacy, Prescribing pattern, Adverse drug reactions, Drug interaction, Bipolar disorder.