Antipsychotic Drug Utilization and Adverse Drug Reaction Profiling in Patients With Schizophrenia at a Tertiary Care Hospital in Western India

Abstract

Introduction Prescription pattern studies conducted in patients with schizophrenia have shown variability in the utilization of antipsychotics based on the geographical location of the study setting. Moreover, there is only a sparse number of studies specifically related to adverse drug reactions (ADRs) in schizophrenia. Hence, a need was felt to study the antipsychotic utilization pattern and adverse drug reactions in patients with schizophrenia in our setting. Methods This was a cross-sectional, observational study conducted at the psychiatry outpatient department (OPD) of a tertiary care hospital in India. Patients diagnosed to have schizophrenia as per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) were included in the study provided they had been prescribed antipsychotic medications at the study center for at least three months. The sociodemographic profile of the patients and caregivers was recorded, and prescription pattern assessment was done using WHO core drug use indicators. Information related to ADRs was recorded, and further assessment was done based on the causality, severity, and preventability of ADRs. Results A total of 250 patients were enrolled in the study. Risperidone (40.25%) and olanzapine (26.32%) were the most commonly prescribed antipsychotic drugs, while trihexyphenidyl was the most frequently prescribed concomitant medication. Among the 37 cases of adverse drug reactions that were recorded, amenorrhea, sedation, and weight gain were found to be the most common. The majority of ADRs were of mild severity in addition to being non-preventable. Conclusion It was observed that atypical antipsychotics were commonly prescribed in the study center, and the majority of the ADRs were mild and not preventable, which shows the adequacy of prescribing practices in the current setting.

A review of interventional schizophrenia trials registered in clinical trials registry of India

“…A study conducted in the psychiatry OPD of a tertiary care hospital in Andhra Pradesh and Mumbai revealed that Olanzapine and Risperidone respectively were currently most used for Schizophrenia. 14,15 However, Olanzapine is associated with dose related lowering seizure threshold and worsens diabetes by impairing glucose tolerance. It is associated with metabolic complications and high risk of stroke in elderly patients.…”

Clinical significance of potential drug–drug interactions in older adults with psychiatric disorders: a retrospective study

“…For example, there were no ADRs among any older adults who used quetiapine in combination with escitalopram. Fourth, the majority of ADRs were mild [32] and preventable [33]. Psychiatrists have taken pDDIs seriously, and have prevented ADRs by controlling drug doses, strengthening monitoring, and taking measures in advance.…”