FACTORS PREDICTING THE USE OF MULTIPLE PSYCHOTROPIC MEDICATIONS

Background: Recent studies have questioned the appropriateness of some types of psychotropic medication prescribing, especially by general p ractitioners. The purpose of this study is to investigate factors that predict prescribing of multiple psychotropic medications, a class tha t may represent more complicated cases. Method: This study analyzed da ta from the 1989 National Ambulatory Medical Care Survey (NAMCS). Mult iple logistic regression methods were used to determine variables that predicted the provision or ordering of multiple psychotropic medicati ons during a single office visit. Results: Patients who visited psychi atrists were six times more likely to receive psychotropics in combina tion than patients visiting general practitioners. Patients diagnosed as manic were four times more likely to receive multiple psychotropics , and those diagnosed as schizophrenic were three times more likely. P atients visiting physicians in the Northeast and South were significan tly less likely to receive psychotropics in combination than patients in the Midwest. Conclusion: Although general practice physicians contr ibute to the use of multiple psychotropic medications, patients visiti ng psychiatric specialists are much more likely to be provided combina tion therapy.