Polypharmacy is a growing public health problem which is affecting multitudes worldwide. Thisemerging public health problem is defined as the routine use of five or more medicines by an individualpatient. Many researchers believe that the prevalence of polypharmacy is going to keep increasingsince more people are being diagnosed with chronic diseases. Polypharmacy is known to cause manyproblems such as adverse drug reactions, drug to drug interactions, wastage of resources and increasedtreatment costs. Countries should raise awareness of polypharmacy and find solutions to this problem. Healthcare professionals should be educated on the dangers of polypharmacy, medication safety andpolypharmacy management. Polypharmacy management means a whole systems approach whichavoids the use of unnecessary medication for multimorbid patients while maximizing pharmaceuticalcare. There is ongoing research to investigate polypharmacy because very little is known in the existingliterature. This article describes polypharmacy in detail, including the prevalence of polypharmacy, theeconomic impact of polypharmacy, medication safety and polypharmacy management. This article aims togive a much deeper insight into polypharmacy.

Background: Multiple drug use is frequently considered to be hazardous for the elderly because of their greater vulnerability to the complications. The purpose of this study was to determine the prevalence of polypharmacy in Tehran and to assess the relative demographic characteristics of patients. Methods: In a cross-sectional study 400 persons aging 55 years and older were interviewed in order to determine the presence of polypharmacy (daily intake of three or more drugs). The cases were randomly selected and asked to answer a questionnaire through interview at home. The questionnaire contained questions about all taking drugs, pattern of using each drug and also patients' personal, social and medical history. Chi-square and fisher exact tests and determination of odds ratios were used in order to data analysis. Results: Medium number of drugs used was 3.4 ± 1.9 in studied cases and %39.6 of cases were exposed to polypharmacy. The prevalence of physician prescribed drug usage was observed to be increased by increasing number of total used drugs in each case (P<0.002). The most commonly used drugs were A.S.A, Atenolol and propranolol and these drugs were prescribed by physician in over than %90 of cases. There was a positive correlations between polypharmacy with referring to multiple physicians (OR=1.96, CI 95%, 1.28- 2.98) (P<0.002) and adverse drug reactions (OR=2.44, CI 95%, 1.47-4.05) (P<0.001). Polypharmacy was more prevalent in the age group of 65-75 years (P<0.04) and lower levels of education (P<0.004) and less prevalent in the group with moderate income (P<0.001).Conclusion: Polypharmacy is common among adults aging 55 years and more in Tehran and is affected by age, education level and economic status.

Prescribing the overdose of medication or polypharmacy for a patient is not principally recommended. Although, studies indicate that the usage of polypharmacy, specially from different groups of medicines, and in particular for refractory patients to treatment, if it is prescribed carefully, not only is beneficial but is necessary too. From the total patients who refer to medical doctors for any reason, 28 to 35 percent suffer from one kind of mental disorder, and those patients whose illnesses are diagnosed as more severe and complex would be referred to psychiatrists by their physicians. Perhaps for that reason, psychiatrists are forced more than any other medical doctors to prescribe polypharmacy. The medication often prescribed as polypharmacy in psychiatry are, 1) antidepressants and benzodiazepins (25%), 2) antipsychotics and antidepressants (17%), and 3) lithum and antidepressants(8%). Among psychiatric patients, the sufferer from mania needs to take polypharmacy more than any other patients to be able to control the symptoms of their illness. Today, considering the peculiarity of psycho-pharmacological medications on one hand, and more complexity of medical treatment in psychiatry on the other also increasing number of the refractory patients to the treatment, it have necessitate gaining adequate and up to date by psychiatrists knowledge for prescribing polypharmacy. This article also argues about the limitations, difficulties, reasoning and the method of applying psychopharmacological drugs in mental disturbances, specially in acute mania.

Background & Aim: The high prevalence of various diseases in elderly people may cause polypharmacy.Administration of the multiple drugs in elderlies makes them prone to side effects and problems related to drug therapy. The purpose of this study was to determine the status of polypharmacy and its related factors among elderlies in Gonabad, 2011.Material & Methods: In this cross-sectional study, 323 elderlies were selected through random stratified sampling method. Data were collected using a 30-item questionnaire including demographic sheet, drug use pattern and its related factors. Validity and reliability of the first questionnaire was determined using content validity and internal proportion and consistency respectively (a-Cronbach’s=0.72). Data was analyzed by descriptive statistics, chi-square and ANOVA using SPSS-PC (v.19).Results: Over 72.1% of the subjects were taking medications. The mean number of medications was 4.06±0.3 per day. Polypharmacy was found in 56.6% of the subjects. Polypharmacy had a significant relationship with sex (P<0.0001), occupation (P=0.004) and medication adherence (P=0.017).Conclusion: According to the findings, polypharmacy is a common problem in the elderlies. Therefore, nurses could play an important role in preventing the risks of polypharmacy in elderly people, through educating seniors and their care givers.

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