Prescriptions of psychotropic and somatic medications among patients with severe mental disorders and healthy controls in a naturalistic study

Abstract

Purpose

Psychotropic and somatic medications are both used in treating severe mental disorders (SMDs). Realistic estimates of the prevalence of use across medication categories are needed. We obtained this in a clinical cohort of patients with SMD and healthy controls (HCs).

Materials and methods

Prescriptions filled at Norwegian pharmacies the year before and after admittance to the Thematically Organized Psychosis (TOP) study were examined in 1406 patients with SMD (mean age 32.5 years, 48.2% women) and 920 HC (34.1 years, 46.2% women). Using data from the Norwegian Prescription Database (NorPD), the number of users in different anatomical therapeutic chemical (ATC) categories was compared using logistic regression. Population estimates were used as reference data.

Results

Use of antipsychotics (N05A), antiepileptics (N03A), antidepressants (N06A), anxiolytics (N05B), hypnotics and sedatives (N05C), anticholinergics (N04A), psychostimulants, attention deficit hyperactivity disorder and nootropic agents (N06B) and drugs for addiction disorders (N07B) was significantly more prevalent in patients with SMD than HC. Use of diabetes treatment (A10), antithrombotic drugs (B01), beta blockers (C07), lipid modifiers (C10), and thyroid and endocrine therapeutics (H03) was also more prevalent in patients with SMD, but with two exceptions somatic medication use was comparable to the general population. Among HC, there was low prevalence of use for most medication categories.

Conclusion

Patients were using psychiatric medications, but also several types of somatic medications, more often than HC. Still, somatic medication use was mostly not higher than in the general population. The results indicate that HC had low use of most medication types.

Keywords:

• Schizophrenia
• bipolar disorders
• psychotic disorders
• prescription drugs
• health register

Disclosure statement

OAA has received speaker’s honorarium from Lundbeck, Janssen and Sunovion and is a consultant for Cortechs.ai. The other authors report no conflicts of interest.

Additional information

Funding

The work was supported by The Research Council of Norway (Grant Numbers 223273, 274359, and 300309) and the South-Eastern Norway Regional Health Authority (Grant Numbers 2019-108 and 2022-073).

Notes on contributors

Dur E. Shahnaz Shafi

Dur E. Shahnaz Shafi, MSc, is currently a pharmacist and working as a pharmacy manager at Vitusapotek, Norway.

Kjetil Nordbø Jørgensen

Kjetil Nordbø Jørgensen, cand. psychol, PhD, is currently a Researcher at the Centre for Precision Psychiatry, Institute of Clinical Medicine, University of Oslo, Norway, and a specialist in clinical psychology at Drammen DPS, Vestre Viken Hospital, Drammen, Norway.

Thomas Bjella

Thomas Bjella, MSc, is currently a Research coordinator at the Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway.

Ragnar Nesvåg

Ragnar Nesvåg, MD, PhD, is currently a department director at Norwegian Institute of Public Health in Oslo, and part-time consultant psychiatrist at Oslo University Hospital.

Ingrid Dieset

Ingrid Dieset, MD, PhD, is currently an Associate Professor at the Institute of Clinical Medicine, University of Oslo, Norway, and a specialist in psychiatry at Oslo University Hospital, Oslo, Norway.

Ingrid Melle

Ingrid Melle, MD, PhD, is currently Professor at the Adult Psychiatry Department, Institute of Clinical Medicine, University of Oslo and the Clinical Psychosis Research Section, Oslo University Hospital.

Ole A. Andreassen

Ole A. Andreassen, MD, PhD, is currently Professor in psychiatry, director of the NORMENT Centre, focusing on translational research from disease mechanisms to clinical impact. Has contributed to better understanding of causal factors of severe mental disorders, including immune factors, and recently focusing on large Nordic biobank and registry data for developing tools for precision psychiatry.

Erik G. Jönsson

Erik G. Jönsson, MD, PhD, is currently Professor Emeritus at the Institute of Clinical Medicine, University of Oslo, Norway and active at the Centre for Psychiatry Research, Department of Clinical Neuroscience & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden.