Pattern of psychotropic prescription in a tertiary care center: A critical analysis

Abstract

Objectives:To study the prescription pattern of psychotropic drugs in a Tertiary Care Hospital in Eastern India with special reference to polypharmacy.Materials and Methods:A total of 411 patients were included in the study through systematic sampling. Patients were diagnosed by a Consultant Psychiatrist before inclusion in the study using a semi-structured interview schedule based on the International Classification of Disease (ICD), classification of mental and behavioral disorders, 10th version). The most recently prescribed psychopharmacological medication of those patients was studied. A checklist to assess the pattern of prescription and evaluate reasons of polypharmacy was filled up by the prescribing consultant.Results:About 76.6% of the patients received polypharmacy in the index study. Males were more exposed to polypharmacy compared to women (80.93% vs. 70.85%). Gender and diagnosis had a predictive value with regard to the polypharmacy. Polypharmacy was more common in organic mental disorders (F0), psychoactive substance abuse disorders (F1), psychotic disorders (F2), mood disorders (F3) and in childhood, and adolescent mental disorders (F9). Most frequently, antipsychotic drugs were prescribed followed by tranquilizers/hypnotics and anticholinergics. Antidepressants (35.13%) were more commonly prescribed as monotherapy. Anticholinergics (100%) and tranquilizers/hypnotics (96.7%) were the drugs more commonly used in combination with other psychotropics. The three most common reasons for prescribing polypharmacy were augmentation (43.8%) of primary drug followed by its use to prevent adverse effects of primary drug (39.6%) and to treat comorbidity (34.9%).Conclusions:Polypharmacy is a common practice despite the research based guidelines suggest otherwise. More vigorous research is needed to address this sensitive issue.

Patterns of Prescription of Psychotropic Medications and Their Adherence among Patients with Schizophrenia in Two Psychiatric Hospitals in Accra, Ghana: A Cross-Sectional Survey

“…Consistent with other studies, olanzapine was the most commonly prescribed psychotropic medication [ 50 ]. Atypical antipsychotics such as olanzapine are more frequently prescribed because they are less likely to cause extrapyramidal side effects as compared with the typical antipsychotics such as haloperidol [ 51 , 52 ].…”

Variation of the prevalence of pediatric polypharmacy: A scoping review

“…On the other hand, studies reporting extremely high prevalence of polypharmacy were likely to be conducted in Asia, in inpatient settings, use overlapping periods less than 31 days, or assess polypharmacy in multiple complex chronic conditions, or multiple medication classes. 5,24,[41][42][43][44][45][46][47][48][49][50][51][52] The median prevalence of polypharmacy in populations using at least one medication was much higher than that of the general population (43.4% vs 27.1%), P < 0.001. Studies that defined polypharmacy with 1 to 30 overlap days had a higher median prevalence than those with greater than 30 overlap days (37.2% vs 23.8%), but both were lower than the overall median prevalence.…”

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

“…[ 19 20 21 22 23 ] Some of the studies from India have also evaluated the prescription patterns of patients with various psychiatric disorders, but these studies have included small number of patients and have been mostly limited to one center only. [ 24 25 26 27 28 29 30 31 32 ] It is often difficult to compare these studies because of the different time frames in which these were conducted. In recent times, a study was published with a large sample size covering patients with different diagnoses, but this study too included patients from one center only.…”