A drug utilization study of antidepressant drugs in a tertiary care hospital
Keywords:Antidepressant, Selective serotonin reuptake inhibitors, Serotonin norepinephrine reuptake inhibitors, Tricyclic antidepressants
Background: In psychiatric practice, antidepressant drugs are widely used group of drugs. Number of drugs are available in this group with diverse type of mechanisms and efficacy/safety profile. The objective for the study was to identify the prescribing pattern of antidepressant drugs in psychiatric patients at a tertiary care hospital and to see the distribution of antidepressant drugs in the sociodemographic group.
Methods: It was a record based descriptive study which was carried out at NKP Salve Institute of Medical Sciences and Research Centre, Nagpur. Case record files of all the patients suffering from depression and other psychiatric disorders and treated with antidepressant drugs during the period of from 1st January 2015 to 31st December 2015 by institutional psychiatrists were analyzed for prescription pattern of antidepressant drugs and their age and sex wise distribution.
Results: A total no. of 300 patients received antidepressant drugs. The most commonly prescribed drug was escitalopram in 121 (40.3%) patients followed by fluoxetine in 61 (20.3%) and clomipramine in 30 (10%) patients. Other drugs that were prescribed were mirtazapine in 24 (8%), nortryptiline in 21 (7%), venlafaxine in 13 (4.3%), fluvoxamine in 12 (4%), amitryptiline in 9 (3%), dothiepin in 5 (1.6%) and duloxetine in 4 (1.3%) patients. Also patients in the age group of 31-40 yrs and 21-30 yrs received most number of antidepressants i.e. 129 (40.3%) and 83 (27.6%) patients respectively. Females have received more antidepressant drugs as compared to males.
Conclusions: Selective Serotonin Reuptake Inhibitors (SSRIs) are the most commonly prescribed group of antidepressant drugs. Escitalopram followed by Fluoxetine were the most commonly prescribed drugs for the management of depression and other psychiatric disorders because of their better efficacy, safety, tolerability and less side effects as compared to TCAs. Females suffer more from depression and other psychiatric disorders as compared to males and the most vulnerable is 21 to 40 yrs of age.
De Battista C, Katzung B. Antidepressant agent. In: (Eds). Basic and Clinical Pharmacology 13th Ed, New Delhi: Mc Graw Hill; 2015:510-530.
Donnell JM, Shelton RC. Drug therapy of depression and anxiety disorders. In: Goodman and Gilmans. The Pharmacological basis of therapeutics 12th Ed, New Delhi: Mc Graw Hill; 397-45.
Avasthi A, Grover S, Aggarwal M. Research on antidepressants in India. Indian J Psychiatry. Jan 2010; 52(1):S341-54.
Memon A, Patel K. Drug use pattern of antidepressant agents in psychiatric patients: A prospective study. NHL Journal of Medical Sciences. 2013;2:2.
Schneeweiss S, Patrick AR, Solomon DH, Mehta J, Dormuth C, Miller M, et al. Variation in the Risk of Suicide Attempts and Completed Suicides by Antidepressant Agent in Adults. Arch Gen Psychiatry. 2010 May;67(5):497-506.
Banerjee I, Roy B, Banerjee I, Sathian B, Mondal M, Saha A. Depression and its Cure: A Drug Utilization Study from a Tertiary Care Centre of Western Nepal. Nepal Journal of Epidemiology. 2011;1(5).
Danesh NA, Landeen J. Relation between depression and sociodemographic factors. Mental Health Syst. 2007;1:4.
Chun-Lee T, Chiang YC, Huang JY, Tantoh DM, Nfor ON, Lee JF, et al. Incidence of Major Depressive Disorder: Variation by Age and Sex in Low-Income Individuals. Medicine (Baltimore). 2016 Apr;95(15):e3110.
Mohanta G, Manavalan R, Prabha K, Prasanna M. Retrospective utilization patterns of antidepressant medications. The Internet Journal of Third World Medicine. 2007;1.
Pinto C1, Trivedi JK, Vankar GK, Sharma PS, Narasimha V. An open-label multicentric study of the tolerability and response to escitalopram treatment in Indian patients with major depressive disorder. J Indian Med Assoc. 2007 Jul;105(7):364,366,368.
Piparva KG, Parmar DM, Singh AP, Gajera MV, Trivedi HR. Drug Utilization Study of Psychotropic Drugs in Outdoor Patients in a Teaching Hospital. Indian J Psychol Med. 2011 Jan-Jun;33(1):54-8.
Grover S, Avasth A, Kalita K, Dalal PK, Rao GP, Chadda RK, et al. IPS multicentric study: Antidepressant prescription patterns. Indian J Psychiatry. 2013 Jan-Mar;55(1):41-5.
Tripathi A, Avasthi A, Desousa A, Bhagabati D, Shah N, Kallivayalil RA, et al. Prescription pattern of antidepressants in five tertiary care psychiatric centres of India. Indian J Med Res. 2016 Apr;143(4):507-13.
Boulenger JP, Huusom AK, Florea I, Baekdal T, Sarchiapone M. A comparative study of the efficacy of long- term treatment with escitalopram and paroxetine in severely depressed patients. Curr Med Res Opin. 2006;22(7):1331-41.
Mathur A, Chowdhary A, Jain M. A comparative study of the efficacy and safety of mirtazapine versus amitriptyline in the treatment of major depression. Indian J Psychiatry. 2002 Jul;44(3):260-5.
Danesh NA, Landeen J. Relation between depression and sociodemographic factors. Int J Ment Health Syst. 2007;1:4.
Motevallyzadeh HR, Baneshi MR, Rameshk M, Nakhaee N. Prescribing Pattern of Antidepressant Drugs among General Practitioners and Psychiatrists: a study from Iran. Russian Open Medical Journal. 2013;2(2).
Lahon AK, Shetty HM, Paramel A, Sharma G. A Retrospective Drug Utilization Study of antidepressants in the Psychiatric unit of a Tertiary Care Hospital. Journal of Clinical and Diagnostic Research. 2011 October;5(5):1069-75 .
Bohra N, Srivastava S, Bhatia MS. Depression in women in Indian context. Indian J Psychiatry. 2015 Jul;57(2):S239-45.