Study objectives: To describe the pharmacoepidemiology
of psychotropic medication prescription in patients recovering from
life-threatening medical and surgical illness.
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.
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.
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