Abstract
Study objectives: To describe the pharmacoepidemiology of psychotropic medication prescription in patients recovering from life-threatening medical and surgical illness. Design: Retrospective analysis of a random sample of medical records. Setting: Regional referral center. Patients: Eighty-nine randomly selected patients transferred from an ICU to the study facility. Interventions: None. Measurements and results: Patients had been treated at the referring ICU for 33 ± 24 days (mean ± SD) and remained at the study hospital for 64 ± 52 days. Most of the patients had prolonged respiratory failure. Nearly half of the patients (47%) received an antidepressant medication while at the facility, and 48% received at least one dose of a benzodiazepine on the first day after transfer. In the sample of 75 patients not prescribed an antidepressant before transfer, 37% were started on therapy with an agent, usually within 3 weeks and predominantly in the selective serotonin reuptake inhibitor or psychostimulant class. Younger patients and those evaluated by a mental health specialist were more likely to be prescribed an antidepressant, compared to other patients. Forty percent of patients were still receiving at least one dose of a benzodiazepine in a 24-h period after their third week at the facility. Conclusion: Although the efficacy of antidepressant pharmacotherapy in patients with comparable severity of medical illness has not been established, a substantial proportion of patients recovering from critical illness at a specialized facility are prescribed antidepressant medications. Benzodiazepine exposure is frequent after transfer, and the prevalence in patients who remain at the facility minimally decreases over time.
Original language | English (US) |
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Pages (from-to) | 547-553 |
Number of pages | 7 |
Journal | CHEST |
Volume | 119 |
Issue number | 2 |
DOIs | |
State | Published - 2001 |
Bibliographical note
Funding Information:Supported by National Heart, Lung, and Blood Institute grants, P50HL50152 and K23HO04073.
Keywords
- Antidepressants
- Benzodiazepines
- Critical illness
- Mechanical ventilation
- Pharmacoepidemiology