A 40 yr old male patient suffering with GERD was initially prescribed with Pantoprazole 40 mg OD for 15 days. After the treatment, suddenly the patient started feeling uncharacterized dizziness and fatigue. The patient consulted his physician who is a gastroenterologist. After a thorough examination the physician asked the patient for blood tests which revealed that the Hb is normal but the amount of Vit.B 12 present in the blood is less than the normal. It was confirmed that, after the use of Pantoprazole, Vit.B 12 blood levels have decreased which lead to the symptoms. This case report summarizes that on long term use of pantoprazole should be supported by supplemental therapy with Vit.B 12. Background: Proton pump inhibitors (PPI) are now one of the most widely used classes of drugs. PPIs have proven to have a very favourable safety profile and it is unusual for a patient to stop these drugs because of side effects. However, increasing numbers of patients are chronically taking PPIs for gastroesophageal reflux disease and a number of other common persistent conditions, therefore the long-term potential adverse effects are receiving increasing attention. One area that is receiving much attention and generally has been poorly studied is the long-term effects of chronic acid suppression on the absorption of vitamins and nutrients.

Psychiatry disorders are creating its own place in morbidity these days. Various factors like cost of drugs, local paradigms, etc, plays a critical role for selecting the appropriate therapy for a particular patient because usually they are chronic therapy. Keeping this in mind, we conducted a study to delineate the various drugs used in psychiatric disorders, to find discrepancies. Drug utilization studies are essential for correct use of drug. Our study identifies the problems that arise from drug usage in health care delivery system and highlights the current approaches to the rational use of drugs. A total of 518 patients’ data were collected during the period and analyzed for WHO recommended prescribing and complementary indicators. Study shows low incidence of poly pharmacy which is good as poly pharmacy is common in psychiatry and also use of injections was very low. Study shows that prescribing from WHO List of Essential Medicine was not as good as it accounted for only 21.3%. There is scope for improvement in case of medicines prescribed by generic name as none were prescribed by generic name. The average cost per prescription in our study was only 9.41 Indian rupees per day which is affordable by the majority of the patients.