Prevalence and factors associated with polypharmacy among patients treated for psychiatric disorders in Palestine

Objectives: Polypharmacy has emerged as a standard clinical practice in treating psychi-atric disorders. This study investigates the prevalence of polypharmacy among patients treat-ed for common psychiatric disorders and the factors associated with this practice. Methods: The current cross-sectional study included all the prescriptions that were issued over the peri-od between October 2018 and January 2019 for patients diagnosed with anxiety, depression, schizophrenia, schizoaffective and bipolar disorders in an outpatient psychiatry clinic in the north of West Bank, Palestine. Results: A total of 1045 prescriptions were analyzed. The mean age of the patients for whom the prescriptions were made was 47.3 years (SD= 13.6); half were between 36 and 55 years old, and one-third were females. Half of the cases were diagnosed with schizophrenia, while the rest were diagnosed with bipolar, depression, schizoaffective, or anxiety. Polypharmacy was found in 877 prescriptions (84%). One-third of the patients have been prescribed two drugs, while one-third received three, and the rest received four or more. Patients with schizophrenia, schizoaffective and bipolar disorders have a higher rate of polypharmacy than patients with anxiety and depression (p=0.000). Pa-tients aged 36 and 55 were more likely to have polypharmacy than younger or older ones (p=0.001). The rate of polypharmacy was not different according to gender. Multi-class, ad-junctive, and same-class polypharmacy was found in 81%, 50%, and 32% of the prescrip-tions. Conclusions: Our results suggest that polypharmacy among psychiatric patients is common in Palestine. Age and diagnosis should pay more attention to selected patients to avoid harmful drug-drug interactions.