<p>Deidentified data (SPSS).</p>

Mental and neurologic disorders are a growing global health concern. Psychotropic medicines are vital for the treatment of these disorders, but issues such as inappropriate prescribing and polypharmacy are prevalent, especially in low- and middle- income countries like Ethiopia. This study assessed psychotropic medicine use patterns in public hospitals of Hadiya zone, Southern Ethiopia. A facility-based cross-sectional study was conducted from June 15 to December 30, 2019, involving the review of 1200 patients medical charts. Data were collected by reviewing the medical charts of patients with mental and neurologic disorders using a data abstraction format. Data were entered and analyzed using SPSS version 26. The results showed that, the most commonly treated mental and neurologic disorders were psychosis (27.50%), followed by schizophrenia (15.67%), epilepsy (13%), and depression (11.92%). Antipsychotics (48.1%) and antidepressants (25.7%) were the most commonly used psychotropic medicines. Chlorpromazine, haloperidol, and thioridazine were the top three most prescribed antipsychotics which constituted 71.34% of antipsychotics use in public hospitals of Hadiya zone. The most commonly prescribed combinations were antipsychotics with antidepressants and antipsychotics with anti-anxiety medicines. Typical antipsychotics were prescribed more often (73.86%) than atypical antipsychotics (26.14%). Among antidepressants, amitriptyline, a tricyclic antidepressant, was most frequently prescribed (74.9%), followed by fluoxetine, selective serotonin reuptake inhibitor (21.5%). Treatment shift was undertaken in 11.5% of patients. The percentage of encounters with two or more psychotropic medicines was 36.1%, which shows a polypharmacy practice. Antipsychotics were the most commonly utilized psychotropic medicines, followed by antidepressants and anticonvulsants. Chlorpromazine, Amitriptyline, and Risperidone showed a higher proportion of utilized medicines. More than one-third of psychiatric patients were prescribed psychotropic polypharmacy. Close to 10% of psychiatric patients had a treatment switch, mostly because of poor improvement, relapse, side effects, and non-adherence. Further prospective continuous studies on both prevalence and use patterns need to be undertaken to get more information.