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When less is more: deprescription in a long-stay hospital. A case report

Published online by Cambridge University Press:  01 September 2022

R. De Hita Santillana ,
A. Cerame  and
M.L. Costa
R. De Hita Santillana*
Affiliation:
Hospital Universitario José Germain, Ucpp, Leganés, Spain
A. Cerame
Affiliation:
Hospital Universitario José Germain, Psychiatry Department, Leganés, Spain Hospital Universitario José Germain, Hospital De Día, Leganes, Spain
M.L. Costa
Affiliation:
Hospital Universitario Severo Ochoa, Psychiatry, Leganes, Spain
*
*Corresponding author.

Abstract

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Introduction

We present the case of a 54-year-old man diagnosed with mixed histrionic / obssesive personality disorder admitted in a long-stay hospital. Symptoms began at 40 years of age, predominantly anxiety and agoraphobia alongside somatic complaints. During his admission, the symptoms markedly fluctuated. The patient alternated periods in which he presented confusion with others of irritability, disinhibition, and stereotyped movements. Moreover the patient spent long periods of time in bed with little or no communication with other patients or staff.

The different pharmacological approaches which were carried out and their consequences are analyzed.

Objectives

It is a common practice to increase the number of prescribed drugs or their doses when symptoms worsen. The result is polymedication and higher doses above maximum levels in the technical sheet. Reducing medication is rarely considered as a strategy.

Methods

A case report is presented alongside a review of the relevant literature regarding different long-term pharmacological treatments and their side effects.

Results

The suspension of the antipsychotic treatment which had been administered for years represented a significant improvement. Withdrawal of Olanzapine resulted in a significant improvement.

Conclusions

It is important to review the prescription of each medication in time, as well as to consider their possible side effects.

Disclosure

No significant relationships.

Keywords

Side effectsdeprescriptionpolymedication
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S729
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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