Pattern of prescription and drug use in psychiatry out patient department of private practitioners of Central India

Chetna A. Shamkuwar, Ashish D. Chakravorty, Meena P. Shrivastava, Ragini Deshmukh

Abstract


Background: Psychotropic drugs have had a remarkable impact in psychiatric practice. The continuous monitoring of prescription and drug utilization studies may help to identify the problem involved in therapeutic decision and promote rational prescribing. Very few studies from India have evaluated the prescription pattern of Psychiatrists. Present study was undertaken to analyze the prescription pattern and drug used in psychiatric Out Patients of private practitioners of Central India.

Methods: One thousand prescriptions were collected by undergraduate students from chemist and analysed. Study parameter like demographic profile of patients viz. age, sex, diagnosis were recorded. Basic drug indicators, the prescribing pattern of antipsychotics and other categories of drugs were also recorded. The most common and, top brands of anti psychotics were analyzed .Inappropriate prescription if any were recorded and analyzed further.

Result: The most common psychotropic drugs were anti-anxiety in 361(36.1%) and antidepressants 130 (13%) prescribed for various psychiatric disorder. Usage of Sedative Hypnotics 104(10.4%), anti-psychotics 90(9%) and anticonvulsants 80 (8%) drugs in prescriptions. The incidence of polypharmacy (22%) was common occurrence in prescriptions. The commonest combination prescribed was of tricyclic antidepressant with benzodiazepines. Central anti-cholinergic was commonly prescribed with anti psychotics.

Conclusions: Anti-anxiety drug (benzodiazepines) was the most frequently prescribed class of psychotropic drugs in various psychiatry disorders. The prescribing prevalence of Alprazolam with different brand names was more than that of other benzodiazepines. The combination of different psychotropic drugs were also prescribed.


Keywords


Prescribing pattern, Private Practitioner, Psychotropic, Antipsychotics, Antidepressants

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References


Victor I Rew. Mental Disorder, Harrisons Principle of Internal Medicine 17th edn. 2008: 2710-2723.

Herbert E Ward and Albert J. Azzaro. Drugs used in Mood Disorders, Modern Pharmacology with clinical Application, 6th edn, 2004: 385-396.

Bauer M, Monz BU, Montejo AL, Quail D, Dantchev N, Demyttenaerek,et al. Prescribing patterns of antidepressants in Europe: result from the factors influencing Depression Endpoints Research Study.Eur Psychiatry 2008; 23:66-73.

Smith S. Gender difference in antipsychotic prescribing .Int Rev Psychiatr Scand 2011; 123: 459-65.

Patterson HR.The problem of audit and Research, JR College Gen Pract 1986;36:196.

Stolley PD, Lasagne L. Prescribing pattern of Physician. J Chron Dis. 1969;22: 395-405.

Trivedi JK, Dayani M, Yadav VS, Rai SB. Antipsychotic drug prescription pattern for schizophrenia: observation from general hospital psychiatry unit. Indian J Psychiatry 2010;52:279.

Grover S, Avasthi A. Anti-psychotic prescription pattern: A preliminary survey of Psychiatrists in India. Indian J Psychiatry 2010;52: 279.

Laporte JR. Towards a healthy use of Pharmaceuticals. Development Dialogue.1988;

-55.

Uppal R, Sharma PL. Prescribing trends in internal medicine International Journal of Clinical Pharmacology Therapy and Toxicology. 22(7) 375-376,1984.

Budhiraja RD. Manual of Practical Pharmacy 2nd edn. Bombay; Popular Prakashan. 1993;6.

Ansari KU. Rational drug therapy- Do we achieve it? Antiseptic 1987; 84: 357-60.

Nies SA, Spielberg SP. Principle of therapeutics In : Hardman IG, Limbard LE, Motinoff PB, Ruddon R Weas. Goodman & Gilman’s The Pharmacological basis of therapeutics 9th edn. New York; Mc Graw Hill Press;1996: 43-62.

Benet LZ. Principle of prescription order writing and patients compliance . In: Goodman AG, Rall TW, NiesAS, Taylor P (eds). Goodman and Gilman’s The pharmacological basis of therapeutics. 8thed. New York : Pergamon Press Inc. 1991: 1640.

Heather A. Toxicity and Adverse consequence of Benzodiazepine use.psychiatric Annals.1995;5:p 158-165. Available from: http: //www.benzo.org.uk /ashox.htmaccessed 17 feb 2011.

Ashton H. Guidelines for the rational use of Benzodiazepines. Drugs 1994;48:25-40.

Jonas JM, Cohon MS. A comparison of the safety and efficacy of Alprazolam versus other agents in the treatment of anxiety, panic and depression: a review of literature. J Clin Psychiatry 1993 Oct ; 54 Suppl 25-45; Discussion 46-8.

World Health Organization. The use of essential drugs WHO Technical Report Series 825.Geneva: World Health Orginzation; 1992.