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Office of Mental Health



Psychotropic polypharmacy refers to the prescription of multiple mental health medications. There is minimal scientific evidence that combining psychotropics is effective, and polypharmacy can have several serious risks, including increased side effects and higher risk for adverse drug-drug interactions. The Polypharmacy quality indicators identify individuals prescribed two or more antipsychotics; two or more antidepressants in the same subclass, or three antidepressants of any kind; and four or more psychotropic medications of any type in adults, or three or more in children. These indicators address longer-term prescription of multiple medications, defined as three months or longer.

The Polypharmacy Reference Guide (272kb) provides:

  • brief definitions of each indicator within the Polypharmacy indicator set,
  • a summary of the scientific evidence regarding polypharmacy
  • clinical recommendations for reducing polypharmacy, and
  • an annotated bibliography of key scientific articles.

Detailed information about the Polypharmacy indicators can be found in the Technical Specifications (312kb).

For QI teams wishing to identify polypharmacy outside of the Medicaid population, a polypharmacy chart review form is available. The Psychotropic Medication Reference Table (386kb) provides information on how medications are classified.

OMH has developed several educational resources about polypharmacy, including:

Comments or questions about the information on this page can be directed to the PSYCKES Team.