‘In the diseases of the mind…it is an art of no little importance to administer medicines properly; but, it is an art of much greater importance and more difficult acquisition to know when to suspend or altogether omit them.’  Philippe Pinel

In the last 30 years there has been a concerning increase in the prevalence of polypharmacy. However, its practice is generally considered to be taboo, and we are taught to avoid it or to use it only as a last resort when treating a patient. Steven Stahl describes polypharmacy as ‘dirty little secret’ and ‘…polypharmacy thus seems to be something everybody does and nobody admits’ (Stahl, 1999).

However, it is important to remember that most medical conditions are treated with more than one medication. Though they may not yet be fully understood, psychiatric disorders are no less complex than physical illnesses, and there is a specific clinical role for polypharmacy in the management of the most difficult-to-treat and resistant psychiatric disorders.

The aim of this module is to familiarise and involve psychiatrists in the debate on polypharmacy, with particular regard to the potential harm as well as benefits that arise from the use of multiple drugs.

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