Indian Psychiatric Society multicentric study: Prescription patterns of psychotropics in India

Abstract

Background:There is a lack of national level data from India on prescription of psychotropics by psychiatrists.Aim and Objective:This study aimed to assess the first prescription handed over to the psychiatrically ill patients whenever they contact a psychiatrist.Materials and Methods:Data were collected across 11 centers. Psychiatric diagnosis was made as per the International Classification of Diseases Classification of Mental and Behavioural Disorders 10th edition criteria based on Mini International Neuropsychiatric Interview, and the data of psychotropic prescriptions was collected.Results:Study included 4480 patients, slightly more than half of the subjects were of male (54.8%) and most of the participants were married (71.8%). Half of the participants were from the urban background, and about half (46.9%) were educated up to or beyond high school. The most common diagnostic category was that of affective disorders (54.3%), followed by Neurotic, stress-related and somatoform disorders (22.2%) and psychotic disorders (19.1%). Other diagnostic categories formed a very small proportion of the study participants. Among the antidepressants, most commonly prescribed antidepressant included escitalopram followed by sertraline. Escitalopram was the most common antidepressant across 7 out of 11 centers and second most common in three centers. Among the antipsychotics, the most commonly prescribed antipsychotic was olanzapine followed by risperidone. Olanzapine was the most commonly prescribed antipsychotic across 6 out of 11 centers and second most common antipsychotic across rest of the centers. Among the mood stabilizers valproate was prescribed more often, and it was the most commonly prescribed mood stabilizer in 8 out of 11 centers. Clonazepam was prescribed as anxiolytic about 5 times more commonly than lorazepam. Clonazepam was the most common benzodiazepine prescribed in 6 out of the 11 centers. Rate of polypharmacy was low.Conclusion:Escitalopram is the most commonly prescribed antidepressant, olanzapine is the most commonly prescribed antipsychotic and clonazepam is most commonly prescribed benzodiazepine. There are very few variations in prescription patterns across various centers.

Drug Utilization Pattern of Psychotropic Drugs in Psychiatric Outpatient Department in a Tertiary Care Teaching Hospital

“…Morbidity pattern among psychiatric disorders showed substance-related disorders (28.71%) as the most common psychiatric disorder followed by schizophrenia and other psychotic disorders (22.77%). This is in contrary to the multicentric study conducted by the Indian Psychiatric Society where affective disorders followed by neurotic, stress-related, and somatoform disorders were the most common diagnostic categories [13]. Higher prevalence of substance use disorders in the present study may be probably due to increase help-seeking behavior for the same in the study population.…”

“…This is similar to the results from the preliminary survey on antipsychotic prescribing pattern conducted among Indian Psychiatrists [15]. The most commonly prescribed antidepressant medication according to our study was escitalopram (57.40%) followed by sertraline (12.96%) which was similar to the findings from a multicentric study conducted by the Indian Psychiatry Society [13]. However, among the mood stabilizers, lithium and sodium valproate were commonly prescribed, followed by carbamazepine which is in contrary to study conducted by the Indian Psychiatry Society and in concordance with the study conducted by Trivedi et al [13,16].…”

Drug Utilization Pattern of Psychotropic Drugs Prescribed in the Psychiatric Department of a Tertiary Care Government Hospital, Rajasthan

“…In our study among atypical antipsychotics, Olanzapine was the most commonly prescribed agent, Our findings closely matches with study of Grover S et al [23,27] The benefit of Olanzapine may be due to its greater efficacy, noticeable improvement of negative symptoms, higher response rate, better maintenance of treatment, and finally lower incidence of adverse effects [28] Typical antipsychotic drugs accounts for 17.79 % of total antipsychotic drug prescriptions indicating that they still play an important role in Schizophrenia and offer a valid alternative to atypical where atypical drugs are poorly tolerated or where typical are preferred by patients themselves.…”

“…[21] In a multicentric study conducted by Grover S et al [23] and Avasthi A et al [31] the most common mood stabilizer prescribed was Valproate . The overall prescribing frequency of Lithium was 1.3% while during the study.…”

Study of prescription pattern in emergency psychiatry in a tertiary care academic hospital of a developing country: a retrospective study

“…Clonazepam use was highest (56.47%), followed by lorazepam (40.6%) in the 1, 4 BNZ group and the only 1, 5 BNZ used was Clobazam. Grover et al 23 in their multicentre study found that among the benzodiazepines clonazepam was most popularly used (64%), followed by lorazepam (14.3%). Similar findings were reported by Rode et al 8 , namely 51.83% for clonazepam and 32.32% for lorazepam.…”