Combination Medications in Psychiatric Treatment: Patterns in a Group of Elderly Hospital Patients*

Abstract

The patterns for treatment with combined medications were studied in a group of elderly male (N = 137) and female (N = 432) psychiatric patients housed in the continuedtreatment services of a state hospital. The combination most frequently used was that of an antidepressant agent with a tranquilizing drug (major or minor). Slightly more than half of all combinations of psychoactive agents prescribed for these patients were composed of a tranquilizer and an antidepressent agent.The combining of particular psychotropic drugs appeared to be related to the sex and age of the patients. Major tranquilizers were used proportionally more often as part of a combination for patients (both sexes) below the age of 70, and proportionally less often for patients aged 70 or older.Certain drugs-perphenazine, chlorprothixene, diazepam and amitriptyline-were used in combinations much more often for female patients than for male patients. Thus the combinations of amitryptyline with chlorprothixene or perphenazine, and of imipramine with diazepam or perphenazine, were used almost exclusively for females. On the other hand, combinations involving the use of thioridazine with triHuoperazine or imipramine were used more often for male than for female patients.

Combination Drug Therapy for the Psychogeriatric Patient: Comparison of Dosage Levels of the Same Psychotropic Drugs, Used Singly and in Combination

“…Despite temporal, geographic and institutional sample differences, the recent data generally are consistent with our earlier observations, i.e., the practice and patterns of combining two or more psychotropic drugs appears to be sex-related (2), age-related (1), and relatively independent of diagnosis or symptoms (5)(6)(7)(8)(9)(10). Additional data seem to support the conclusion that there is no sound theoretic or empiric rationale for the use of most psychotropic drug combinations (11).…”

“…Since our initial surveys of pharmaceutical prescribing practices at a large state mental hospital (1,2), a number of reports describing patterns of psychoactive drug usage in psychiatric hospitals have appeared in the literature (3,4). In view of the previous paucity of data on this subject, this increment almost qualifies as an "information explosion."…”

Newer Psychotropic Medication Use in Nursing Home Residents

“…The use of psychoactive medications in nursing homes has been reported for more than 4 decades 1–4 . With the growing number of pharmacologic agents, expansion into clinical geriatric practice followed, 5 particularly in nursing homes where a majority of residents have psychiatric illnesses 6–9 . Reported rates of psychoactive drug use in US nursing homes ranges from 11% 10 to 35% 11,12 to nearly 90%, 13 with the majority of studies reporting rates of greater than 50% 14–25 .…”

Treatment Patterns in Psychiatry: Relationships to Symptom Features and Aging

“…A study of 539 older male and female psychiatric patients treated with drug combinations (polypharmacy) at Central Islip State Hospital has indicated that the pattern of polypharmacy appears to be an age-related phenomenon (1). The use of major tranquilizers as part of a drug combination decreased with increasing age of the patients, while the use of minor tranquilizing agents increased.…”