Gender Differences in Psychotropic Medication Use: A Naturalistic Study Among Psychiatric Outpatients in Secondary Care.

Purpose/background: Previous studies among psychiatric patients have shown differences between men and women in psychotropic medication prescription patterns. The factors underlying these differences are still poorly understood. This exploratory study aimed to investigate a range of clinical and demographic factors in their contributions to explaining these gender differences.

Methods/procedures: In 2476 outpatients with a mental disorder (mean age 46.1 year, 58.2% women) enrolled in pharmacotherapy monitoring program, regression analyses were used to investigate the associations of gender with use of any psychotropic (yes/no), use of each separate psychotropic type (yes/no), number (0 to 4) and dosage of each used psychotropic. Next, clinical and demographic effect modifiers and explanatory/confounding factors of these associations were identified.

Findings/results: Frequencies of general psychotropic use, antidepressant use, anxiolytic use, as well as polypharmacy were significantly higher in women than in men across all ages (premenopausal, perimenopausal, and postmenopausal), with equal dosing of psychotropics, except for higher doses of mood stabilizers in men. Longer illness duration and having a partner were effect modifiers of the gender effect, while higher frequencies of an affective/anxiety diagnosis, higher somatic complaints and symptomatic distress, more previous mental health service (MHS) visits and no current occupation were explanatory factors.

Implications/conclusions: Psychotropic use and psychotropic polypharmacy were more common in women than in men. Women on psychotropic medications were more often diagnosed with affective/anxiety diagnoses, experienced more symptomatic distress and somatic complaints, and visited more healthcare services than men, reaffirming findings from previous studies. Future longitudinal studies should investigate in further detail whether these outcomes are cause or consequence of gender differences in psychotropic medication use.