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

Abstract

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.