Publication:

A study on drug prescribing pattern in psychiatry out-patient department from a tertiary care teaching hospital

Background The burden of illness resulting from psychiatric and behavioral disorders is enormous; although, it remains grossly under represented by conventional public health statistics, which focus on mortality rather than the morbidity or dysfunction. Therefore, the study was carried out to find out morbidity pattern of psychiatric diseases and prescribing trends of psychotropic drugs.

Methods A prospective observational study was conducted in psychiatry out-patient department of a tertiary care hospital for 3 months. Diagnosis was made according to ICD-10 criteria. Prescription pattern was analyzed using World Health Organization (WHO) drug indicators.

Results Of 520 patients analyzed, 52.31% were males and 47.69% were females, 72.31% were <45 years. Depression 42.88%, schizophrenia 23.08%, bipolar mood disorders 17.88%, and anxiety 9.04% accounted for 92.88% of cases. Among the total of 1092 psychotropic drugs prescribed, 1056 (96.7%) were oral formulations. Average number of psychotropic drugs per prescription was 2.1 ± 0.8. 20.58% of the prescriptions contained fixed dose combinations. About 28.75% drugs were prescribed by generic name. Utilization from the WHO and National essential medical list were 28.57% and 38.64%, respectively. The prescribing frequency of anxiolytics, anti-depressants, anti-psychotics, anti-cholinergics, and anti-mania drugs was 30.04% (328/1092), 25.46% (278/1092), 25.37% (277/1092), 11.54% (126/1092), and 7.6% (83/1092), respectively. Clonazepam, olanzapine, escitalopram, carbamazepine and trihexyphenidyl were the most commonly prescribed benzodiazepines (BZD), antipsychotic, antidepressants, mood stabilizer and anti-cholinergics, respectively.

Conclusion Utilization pattern of the psychotropic drugs were in accordance to the recommendations of various treatment guidelines. BZD were the most commonly prescribed psychotropic drugs.