DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20172726

Study on drug usage pattern of anxiolytics in psychiatric department in a tertiary care teaching hospital at Dehradun, Uttarakhand, India

Shakti B. Dutta, Mirza A. Beg, Shalu Bawa, Amanjot Kaur, Subhash Vishal, Nand Kishore Singh

Abstract


Background: Psychopharmacology is a rapidly growing field, in which the number of patients is continuously increasing. Newly introduced drugs are projected as the better alternative to the traditional psychiatric medicines. The utilization and consequences on real life effectiveness and safety of antianxiety drugs in actual clinical practice need continuous monitoring. Aim of the present study was to analyze the pattern of various anxiolytic drugs prescribed to the patients in psychiatric department of a tertiary care teaching hospital.

Methods: The present study was conducted by the department of pharmacology, in the department of psychiatry at SGRRIM and HS, Dehradun, for a period of 6 months from June 2016 to December 2016. Prescriptions of patients diagnosed with anxiety were analysed, using WHO drug use indicators.

Results: A total of 603 prescriptions with anxiety disorder were collected. The mean age was 35.46±0.88 years. Majority of the patients were in 31-50 years age group 309 (51.24%). Male:Female ratio was 1:0.69. Disease pattern observed during the study were 177 (29.35%) generalized anxiety disorder, 147 (24.38%) depression, 99 (16.42%) obsessive compulsive disorder (OCD), 81 (13.43%) psychotic illness, 63 (10.45%) bipolar disorders and 36 (5.97%) patients categorized as others category respectively. A total of 1974 psychotropic drugs were prescribed, 654 (33.13%) antianxiety drugs, 648 (32.83%) antidepressants, 240 (12.16%) antipsychotics, 198 (10.03%) antiepileptics and 234 (11.85%) miscellaneous drugs were prescribed. 552 (91.54%) patients received monotherapy and 51 (8.46%) were given polytherapy of anxiolytics. All (100%) anxiolytics were orally prescribed. A total of 30 fixed dose combinations (FDCs) of anxiolytics were prescribed. The numbers of anxiolytics per prescription were 1.085. The anxiolytics prescribed from National Essential Medicine List 2015 were 555 (84.86%). The percentage of anxiolytics with brand names were 618 (94.5%).

Conclusions: Most of the prescriptions were rational but there is a need to encourage prescribing by generic names so that more cost-effective and rational treatment can be provided to the patients.


Keywords


Anxiolytics, Drug utilization, Psychopharmacology, Rational prescribing

Full Text:

PDF

References


Trivedi JK, Gupta PK. An overview of Indian research in anxiety disorders. Indian J Psychiatry. 2010;52(1):S210-8.

Solanki G. Anti-Anxiety Drugs. An Overview. International Journal of Biomedical Research. 2013 Feb 1;4(1):1-4.

Bandelow B, Wedekind D, Leon T. Pregabalin for the treatment of generalized anxiety disorder: a novel pharmacologic intervention. Expert Rev Neurother. 2007;7(7):769-81.

Clark RH, Bloom BT, Spitzer AR, Gerstmann DR. Reported Medication Use in the Neonatal Intensive Care Unit: Data from a Large National Data Set. Paediatrics. 2006;117:1979-7.

ESEMeD/MHEDEA 2000 investigators: Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental disorders (ESEMeD) project. Acta Psychiatrica Scandinavica. 2004;109(420):21-7.

Davidson JR, Feltner DE, Dugar A. Management of generalized anxiety disorder in primary care: identifying the challenges and unmet needs. Prim Care Companion J Clin Psychiatry. 2010;12(2).

Lesen E, Anderrson K, Petzoid M, Carlsten A. Socioeconomic determinants of Psychotropic drug utilization among elderly: a national population based cross sectional study. BMC Public Health. 2010;10(118):1-9.

Rao TSS, Darshan MS, Tandon A, Raman R, Karthik KN, Saraswathi N, et al. Suttur study: An epidemiological study of psychiatric disorders in south Indian rural population. I J of Psy. 2014;56(3):238-5.

Chakos M, Lieberman J, Hoffman E, Bradford D, Sheitman B. Effectiveness of second-generation antipsychotics in patients with treatment-resistant schizophrenia: a review and meta-analysis of randomized trials. Am J Psychiatry. 2001;158(4):518-6.

Ghosh S, Bhattacharyya S, Bhattacharya A. Medications for anxiety: A drug utilization study in psychiatry outpatients from a tertiary care centre of Eastern India. Journal of Drug Delivery and Therapeutics. 2013;3(4):79-4.

Chandrashekhar CR, Reddy MV. Prevalence of mental and behavioural disorders in India: A metaanalysis. Indian J Psychiatry. 1998;40:149-7.

Dutta S, Beg MA, Kaul V, Dutta SH, Dhasmana DC. Psychotropic drug utilization study in psychiatric OPD of a tertiary care teaching hospital in Dehradun, Uttarakhand. J Adv Res Biol Sci. 2013;5(4):386-1.

Jacobson GA, Friesen WT, Peterson GM, Rumble RH, Polack AE. Psychoactive drug prescribing in the Tasmanian community. Med J Aust. 1992;157(1):20-4.

Banerjee R, Sathian B, Banerjee KS, Saha A. Medications for Anxiety: A Drug utilization study in Psychiatry inpatients from a Tertiary Care Centre of Western Nepal. Nepal J of Epi. 2011;1(4):119-5.

Jena M, Mishra S, Mishra SN, Mishra SS. Psychotropic drugs: Prescribing pattern in Psychiatry Outpatient Department of a tertiary care teaching hospital. Int J Pharm. 2014;4(4):204-8.

Lader MH, Bond AJ, James DC. Clinical comparison of anxiolytic drug therapy. Psychol Med. 1974;4:381-7.

Dutta SB, Beg MA, Sindhu S, Singh NK. Role of pharmaco-epidemiology in psychopharmacology: a study in psychiatric out-patient department of a tertiary care teaching hospital at Dehradun, Uttarakhand. Int J Basic Clin Pharmacol. 2014;3(4):637-3.

Rittmannsberger H, Meise U, Schauflinger K, Horvath E, Donat H, Hinterhuber H. Polypharmacy in psychiatric treatment. Patterns of psychotropic drug use in Austrian psychiatric clinics. Eur Psychiatry. 1999;14(1):33-40.

Trumic E, Pranjic N, Begic L, Becic F, Asceric M. Idiosyncratic adverse reactions of most frequent drug combinations long term use among hospitalized patients with polypharmacy. Med Arh. 2012;66(4):243-8.

Sahana DA, Keshava P, Rajeshwari S, Ullal SD, Rathnakar UP, Jaykumar JS. Pattern of psychotropic drug usage in psychiatric illnesses among elderly. J Med Dev Ctries. 2010;2(1):3-10.

Shankar PR, Roy S. Patterns of prescription and drug use in a psychiatry out-patient department in a teaching hospital in Western Nepal. Internet J Pharmacol. 2002;1(2):1-6.