DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20173111

Utilization pattern of antidepressants in psychiatry wards of a tertiary care hospital in South Kerala, India

Resmi Douglas, Manju K. Nair

Abstract


Background: Depression is an important public health problem causing impairment of social, occupational and other important areas of function. This study was done to evaluate the utilization pattern of antidepressants in the psychiatry wards of a tertiary care centre in South Kerala.

Methods: This retrospective study was carried out in a tertiary care centre of South Kerala from January to March 2016 among 52 inpatients treated with psychotropic drugs for different psychiatric ailments. Data was collected from their case records and analysed using Microsoft excel 2010. Results were expressed in proportions.

Results: Case record review of 52 patients showed that married persons and females suffered more from depression (69.2%). Bipolar disorder was the most common diagnosis (80.8%). Selective serotonin reuptake inhibitor (SSRI) was the most commonly prescribed antidepressant followed by atypical antidepressants. Escitalopram was the most commonly prescribed SSRI, followed by Sertraline. 86.5% required antipsychotics for controlling their psychotic symptoms. One fourth of the patients had hypothyroidism. 7.69 % patients required Electroconvulsive therapy (ECT). 5.7% patients developed adverse drug reactions like cogwheel rigidity, neurolept malignant syndrome and Valproate induced hyperammonemia.

Conclusions: Most common diagnosis was bipolar illness with majority requiring sodium valproate as treatment. SSRI was preferred among antidepressants. Prompt diagnosis, use of appropriate psychotropic drugs and psychotherapy can improve the quality of life in these patients.


Keywords


Antidepressants, Antipsychotics, Bipolar disorder, Utilization pattern

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References


Sadock BJ. Signs and symptoms in Psychiatry, Chapter 7.3. In: Benjamin James Sadock MD, Virginia Alcott Sadock, Pedro Ruiz MD, eds. Kaplan and Sadock's comprehensive textbook of psychiatry, 9th Ed. Wolter Kluwer/Lippincott Williams and Wilkins. Vol 1:923.

Mishra A, Swain TR, Mohanty MA. Patterns of prescription and efficacy evaluation of antidepressants in a tertiary care teaching hospital in eastern India. Asian J Pharm Clin Res. 2012;5:19-22.

Ray S, Chogtu B. Prescribing trends in depression: a drug utilization study done at a tertiary healthcare centre. J Clin Diag Res. 2011;5(3):573-7.

Kessler RC, Aguilar-Gaxiola S, Alonso J, Chatterji S, Lee S, Ormel J, et al. The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiology and Psychiatric Sciences. 2009 Mar;18(1):23-33.

Menon A, Patel K. Drug use pattern of antidepressant agents in psychiatric patients-A prospective study. NHL Journal of Medical Sciences. 2013;2(2):33-6.

Morabia A, Fabre J, Dunand JP. The influence of patient and physician gender on the prescription of psychotropic drugs. J Clin Phar. 1992;45:111-6.

The ESSMeD / MHEDEA 2000 investigators. Psychotropic drug utilization in Europe: results from the European Study of the Epidemiology of Mental Disorders [ESEMeD] project. Acta Psychiatr Scand. 2004;109(420):55-64.

Uchida N, Chong MY, Tan CH, Nagai H, Tanaka M, Lee MS, et al. International study on antidepressant prescription pattern at 20 teaching hospitals and major psychiatric institutions in East Asia: Analysis of 1898 cases from China, Japan, Korea, Singapore and Taiwan. Psychiatry and clinical neurosciences. 2007 Oct 1;61(5):522-8.

Olfson M, Marcus SC, Pincus HA, Zito JM, Thompson JW, Zarin DA. Antidepressant prescribing practices of outpatient psychiatrists. Archives of General Psychiatry. 1998 Apr 1;55(4):310-6.

Hemels ME, Koren G, Einarson TR. Increased use of antidepressants in Canada: 1981-2000. Annals of Pharmacotherapy. 2002 Sep;36(9):1375-9.

Hansen DG, Sondergaard J, Vach W, Gram FL, Rosholm JU, Kragstrup J. Antidepressant drug use in general practice: inter-practice variation and association with practice characteristics. European journal of clinical pharmacology. 2003 Jun 1;59(2):143-9.

Pirraglia PA, Stafford RS, Singer GE. Trends in the prescribing of SSRI and other newer antidepressant agents in adult primary care. Primary care companion. J Clin Psy. 2003;5:153-7.