Prescribing patterns in an outpatient psychiatric clinic

Abstract

Prescribing patterns were studied in a psychiatric outpatient clinic. Psychiatrists tended to prescribe large quantities of antidepressants or other drugs. In contrast, the daily doses for antidepressants and neuroleptics were often too low. Significant variations were noted between three outpatient clinics in the choices among a various psychotropic drugs from a given therapeutic group.

Prescription pattern of antidepressants in out-patient psychiatric practice

“…However, it is difficult to compare our data with those reported in the literature, because very often depressed patients were studied in primary care settings, as opposed to specialized ones. The few studies conducted in psychiatric settings include those of Holloway (1988), Schulz et al (1984), and Glick et al (1991). Holloway found that out of 28 patients receiving antidepressants in a district psychiatric service, five needed an increase in dose or substitution with a more effective antidepressant.…”

“…The author attributed these inappropriate prescribing practices to the fact that the drug management of these patients was largely in the hands of junior psychiatrists and general practitioners. Schulz et al (1984) found that out of 53 prescriptions for antidepressants, 18 were 50 mg or less, and attributed this finding to a moderate prescribing position of European psychiatrists in comparison with North American colleagues. Finally, Glick et al in a thorough study of the treatment and outcome of major affective disorders, showed that patients with the best resolutions received more adequate medication than patients with the worst outcomes.…”

“…However, prescription patterns have yet to be adequately described. Available studies usually report the average dose of a given antidepressant administered to a group of patients, or the percentage of patients for whom a given dose threshold was not reached (Schulz et al 1984;Holloway, 1988). Little is known about the characteristics of the patients associated with inadequate prescription, and ultimately about the reasons why doctors in clinical practice seem to prefer low doses.…”

Psychotropic drug utilization and audit in two Italian psychiatric services

“…In terms of the investigations listed in Table 1, the number of patients included in the present study was relatively small. However, the surveys of Gottschalk et al (1971), Winstead et al (1976), Morgan & Gopalaswamy (1984) and Schulz et al (1984) were smaller still, and the present sample represented about one-third of all the admissions to the Cremona psychiatric services during the year. The mental health services in Italy have undergone dramatic changes in recent years, but relatively few evaluative studies have been conducted .…”