Polypharmacy: causes and consequences

‘In the diseases of the mind…it is an art of no little importance to administer medicines properly; but, it is an art of much greater importance and more difficult acquisition to know when to suspend or altogether omit them.’ Philippe Pinel

Steven Stahl describes polypharmacy as a ‘dirty little secret’ and ‘…polypharmacy thus seems to be something everybody does and nobody admits’ (Stahl, 1999). Polypharmacy has increased manifold in the last 30 years.

However, it is important to remember that most medical conditions are treated with more than one medication. Psychiatric disorders are no less complex than physical illnesses, and there is a specific clinical role for polypharmacy in the management of the most difficult-to-treat and resistant psychiatric disorders.

The aim of this module is to familiarise and involve psychiatrists in the debate on polypharmacy, with particular regard to the balance between benefits and harms using multiple drugs.