Antipsychotics in schizophrenia: a retrospective study of drug utilization pattern in outpatient department of psychiatry at a tertiary care hospital

Authors

  • Usharani H. Patted Department of Pharmacology, Mysore Medical College and Research Institute, Mysore, Karnataka, India
  • Hema N. G. Department of Pharmacology, Mysore Medical College and Research Institute, Mysore, Karnataka, India
  • Anil Kumar Mysore Nagaraj Department of Psychiatry, K.R Hospital, Mysore Medical College and Research Institute, Mysore, Karnataka, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20175694

Keywords:

Antipsychotics, Drug utilization study, Outpatients, Psychiatry

Abstract

Background: Psychiatric disorders are one of the major causes of morbidity and the burden of illness is enormous and remains grossly under represented. Psychotropic drugs have had a remarkable impact in psychiatric practice. Currently a large number of atypical antipsychotics available in the market are endorsed as better options for treating schizophrenia than the typical antipsychotics. The main objective of the study was to find the commonly prescribed antipsychotics in schizophrenia patients in a tertiary care center.

Methods: After Institutional Ethics Committee approval, a retrospective cross-sectional drug utilization study of 400 prescriptions was under taken from 1st July 2015 to 30th July 2016 in the outpatient department of psychiatry of a tertiary care hospital. The prescribing pattern of antipsychotics in schizophrenia patients (N=107) was measured.

Results: Out of 400 cases in the outpatient department, schizophrenia cases were predominant (N=107 i.e. 27%) out of which 42.1% were females and 57.9% were males. This was followed by mood disorders and neurotic & somatoform disorders. The most common antipsychotic used was olanzapine followed by risperidone. Least commonly used antipsychotic was haloperidol. Most of the patients who received risperidone also received an anticholinergic trihexyphenidyl (91.8%).

Conclusions: Olanzapine and risperidone are the most commonly used antipsychotics. Anticholinergics should be used only in selected patients on antipsychotics as tolerance develops to extrapyramidal side effects. Anticholinergics are unnecessary after 3-6 months in all except 10% of patients. Moreover, it has its own side effects and adversely interacts with antipsychotics.

References

Owen MJ, Sawa A, Mortensen PB. Schizophrenia. Lancet. 2016;388(10039):86-97.

Schizophrenia. In: WHO, 2017. Available at: http://www.who.int/mental_health/management/schizophrenia/en/s. Accessed 29 October2017.

Schizophrenia facts and statistics. 2017. Available at: http://www.schizophrenia.com/szfacts.htm. Accessed 29 October 2017.

Berger A, Edelsberg J, Sanders KN, Alvir JMJ, Mychaskiw MA. Medication adherence and utilization in parents with schizophrenia or bipolar disorder receiving aripiprazole, quetiapine or ziprasidone at hospital discharge: A retrospective cohort study. BMC Psychiatry. 2012;12:99.

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;33(1):54-8.

Deshmukh SA, Shaikh TS. Evaluation of psychotropic drugs use pattern among out patients attending psychiatry department at government medical college and hospital, Nagpur: A cross sectional study. Int J Pharm Bio Sci. 2012;3(3):428-36.

Rode SB, Ajagallay RK, Salankar HV, Sinha U. A study on drug prescribing pattern in psychiatry out-patient department from a tertiary care teaching hospital. Int J Basic Clin Pharmacol. 2014;3(3):517-22.

Banerjee I, Roy B, Sathian B, Banerjee I, Chakraborthy PK, Saha A. Sociodemographic profile and utilization pattern of antipsychotic drugs among schizophrenic inpatients: a cross sectional study from western region of Nepal. BMC Psychiatry. 2013;13:96.

Chong MY, Tan CH, Fujii S, Ungyari GS, Si T, Chung EK, et al. Antipsychotic drug prescription for schizophrenia in East Asia: rationale for change. Psychiatry Clin Neurosci. 2004;58(1):61-7.

Cheung S, Hamuro Y, Mahlich J, Nakahara T, Sruamsiri R, Tsukazawa S. Drug utilization of Japanese patients diagnosed with schizophrenia: An administrative database analysis. Clin Drug Investig. 2017;37(6):559-69.

Paul PK, Konwar M, Das S. To study the prescribing pattern of antipsychotic drugs in a tertiary care hospital of Assam. Int J Pharm Pharm Sci. 2014;6(4):435-7.

Rode SB, Ajagallay RK, Salankar HV, Sinha U. A study on drug prescribing pattern in psychiatry out-patient department from a tertiary care teaching hospital. Int J Basic Clin Pharmacol. 2014;3(3):517-22.

Thakkar KB, Jain MM, Billa G, Joshi A, Khobragade AA. A drug utilization study of psychotropic drugs prescribed in the psychiatry outpatient department of a tertiary care hospital. J Clinic Diag Res. 2013;7(12):2759-64.

Atif M, Sarwar MR, Azeem M, Umer D, Rauf A, Rasool A, et al. Assessment of WHO/INRUD core drug use indicators in two tertiary care hospitals of Bahawalpur, Punjab, Pakistan. J Pharma Policy Practice. 2016;9:27.

West JC, Marcus SC, Wilk Joshua, Countis LM, Regier DA, Olfson M. Use of depot antipsychotic medications for medication nonadherence in schizophrenia. Schizophrenia Bulletin. 2008;34(5):995-1001.

Practice guidelines for the treatment of patients with schizophrenia, 2004. Available at: http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/schizophrenia.pdf. Accessed 27 October 2017.

Role of anticholinergic medications in patients requiring long-term antipsychotic treatment for psychotic disorders, 2012. Available at: http://www.who.int/mental_health/mhgap/evidence/resource/psychosis_q6.pdf?ua=1. Accessed 27 October 2017.

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Published

2017-12-23

How to Cite

Patted, U. H., G., H. N., & Nagaraj, A. K. M. (2017). Antipsychotics in schizophrenia: a retrospective study of drug utilization pattern in outpatient department of psychiatry at a tertiary care hospital. International Journal of Basic & Clinical Pharmacology, 7(1), 167–172. https://doi.org/10.18203/2319-2003.ijbcp20175694

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Original Research Articles