Determinants of psychotropic drug usage in a general intensive care unit

During a 3-month period, determinants of psychotropic drug utilization (sex , age, length of stay, reason for admission, disease severity) and data on psychotropic consumption (type of medication-antidepressants, benzodiazepin es and antipsychotics-dosage and length of treatment) were retrospectively collected in a general intensive cave unit of a Dutch university hospital. Daily exposure to psychotropics was standardized in number of Defined Daily Doses (DDD). Benzodiazepines were used by 35.8% of all patients (137) duri ng their stay in the ICU whereas 17.5% of all patients used a neuroleptic a gent. Antidepressants were hardly prescribed. High doses of benzodiazepines (9.9 DDDs) and low doses of antipsychotics (0.5 DDDs) were prescribed, whi ch probably reflect the unusual nature of this critically ill group of pati ents compared with the reference group for DDD's. Clear patterns of determi nants of psychotropic drug use in ICU patients were found and both benzodia zepines, antipsychotics and combined use of these agents could be associate d with the determinants assessed. The time patterns we found in terms of le ngth of stay give clues for further investigations in order to rationalize psychotropic drug use in the management of severely ill and complex patient s. (C) 1998 Elsevier Science Inc.