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Published Online: 16 October 2017

Surveying Psychiatrists’ Psychopharmacology Practices Across Common Clinical Scenarios

Abstract

The practice of psychopharmacology has become increasingly complex with the expansion of medication options across psychiatric conditions. The level of variability among psychiatrists in their application of medication treatments has received little attention to date. We surveyed 111 psychiatrists attending one of two annual psychiatry meetings in 2017, asking whether they agreed or disagreed with statements about psychopharmacological approaches to 14 common clinical scenarios. High consistency was found for six scenarios, which generally reflected published treatment guidelines, and in recommending that their patients avoid using marijuana. However, low consistency was found for seven scenarios, particularly for statements addressing the use of benzodiazepines and antipsychotic medications. These statements of low consistency generally reflected contradictions or ambiguity across treatment guidelines. In comparison with male psychiatrists, female psychiatrists’ responses revealed greater caution around use of medications with addictive potential. Responses to statements were not associated with psychiatrists’ perceived adequacy of psychopharmacology training received during residency. Although psychiatrists have high consistency in some aspects of psychopharmacological practice, significant variability exists in important areas of medication use. The consistency of psychotropic medication prescribing may be improved through conducting practical clinical trials that address the existing evidence gaps and by developing educational materials targeting areas of prescriber disagreement.

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History

Published in print: Fall 2017
Published online: 16 October 2017

Keywords

  1. Antidepressants
  2. Antipsychotics
  3. Antianxiety Agents
  4. Drug treatment/psychopharmacology
  5. Practice guidelines

Authors

Details

Boadie W. Dunlop, M.D., M.S. [email protected]
Drs. Dunlop and Rakofsky are with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA.
Jeffrey J. Rakofsky, M.D.
Drs. Dunlop and Rakofsky are with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA.

Notes

Send correspondence to Dr. Dunlop (e-mail: [email protected]).

Funding Information

Dr. Dunlop has received research support from Acadia, Assurex, Axsome, Janssen, NIMH, Otsuka, and Takeda. Dr. Rakofsky has received research support from Assurex, Janssen, NIMH, and Takeda.

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