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Clinical Investigations in Critical Care |

Epidemiology of Psychiatric Medication Use in Patients Recovering From Critical Illness at a Long-term Acute-Care Facility*

Craig R. Weinert, MD, MPH
Author and Funding Information

*From the Department of Medicine, University of Minnesota, Minneapolis, MN.

Correspondence to: Craig R. Weinert, MD, MPH, Department of Medicine, University of Minnesota, MMC 276 Mayo, 420 Delaware St, SE Minneapolis, MN 55455; e-mail: weine006@tc.umn.edu



Chest. 2001;119(2):547-553. doi:10.1378/chest.119.2.547
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Published online

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.

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