Romanian Society of Pharmaceutical Sciences
 

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PSYCHOTROPIC POLYPHARMACY AT PSYCHIATRIC DISCHARGE – PATTERNS OF BENZODIAZEPINE, Z-HYPNOTIC AND ANTIPSYCHOTIC CO-PRESCRIPTION

ALEXANDRU MISCHIE 1, LIANA DEHELEAN 2*, ALEXANDRA ENACHE 3, RAMONA AMINA POPOVICI 4, DORA MIHAELA CÎMPIAN 5, CRISTINA BODO 5, SONIA ȘUT 6, ADRIAN CIOLOCA 7, ELENA GABRIELA STRETE 8, ANDREEA SĂLCUDEAN ⁵

¹ Doctoral School, Victor Babeș University of Medicine and Pharmacy Timișoara, Romania
2 Department of Psychiatry, Victor Babeș University of Medicine and Pharmacy Timișoara, Romania
3 Discipline of Forensic Medicine, Bioethics, Deontology, and Medical Law, Department of Neuroscience, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania
4 Faculty of Dental Medicine, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania
5 Department of Bioethics, Medical Deontology and Medical Communication, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Târgu Mureș, Romania
6 Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Gheorghe Marinescu Street, No. 38, Târgu Mureș, Romania
7 Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Gheorghe Marinescu Street, No. 38, Târgu Mureș, Romania
8 Department of Psychiatry, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania

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Psychotropic polypharmacy at discharge from Romanian psychiatric wards has rarely been quantified. We analysed pseudonymised discharge documents from an adult psychiatric ward in Timișoara, Romania. Medications were extracted with a large language model-assisted pipeline, completed by a dictionary search of the discharge text, mapped to international non-proprietary names and grouped by class. Of 1,391 adult eligible episodes, 1,245 (89.5%) listed at least one psychotropic. The median number of distinct psychotropic substances was 5 (interquartile range 4 - 6); 92.1% of episodes listed three or more. Benzodiazepines appeared in 86.4% of regimens, Z-hypnotics in 75.0% and both together in 69.8%. Antipsychotic polypharmacy affected 41.7% of antipsychotic-treated episodes and was associated with long-acting injectable formulations, mood stabiliser co-prescription and male sex. Antipsychotics appeared in 65.1% of non-psychotic depressive episodes. Extraction was not validated against source documents; indication, dose and duration were unavailable, so the estimates describe listed regimens, not their appropriateness.