Patterns of psychotropic medication use in inpatient and outpatient psychiatric settings in Saudi Arabia

Abstract

ObjectiveTo study the pattern of psychotropic medication use and compare this pattern between inpatient and outpatient psychiatric settings in Saudi Arabia.MethodThis cross-sectional observational study was conducted between July 2012 and June 2014 on patients seeking psychiatric advice at major hospitals in five main regions of Saudi Arabia. Male (n=651) and female (n=594) patients who signed the informed consent form and were currently or had been previously using psychotropic medications, irrespective of the patient’s type of psychiatric diagnosis and duration of the disease, were included. A total of 1,246 patients were found to be suitable in the inclusion criteria of whom 464 were inpatients while 782 were outpatients.ResultsSeveral studied demographic factors have shown that compared with outpatients, inpatients were more likely to be male (P=0.004), unmarried (P<0.001), have less number of children (1–3; P=0.002), unemployed (P=0.001), have a lower family income (<3,000 SR; P<0.001), live in rural communities (P<0.001), have a lower body mass index (P=0.001), and are smokers (P<0.001); however, there were no differences with regard to age or educational levels. The current frequency of use of psychotropic medications in overall patients was antipsychotics (76.6%), antidepressants (41.4%), mood stabilizers (27.9%), and antianxiety (6.2%). However, compared to outpatients, the current use of medications for inpatients was more frequent (93.8% vs 89.9%, P=0.019) with inpatients more likely to be treated with multiple medications (2.1 vs 1.8 medications). A similar trend was observed in the case of antipsychotics, high potency first-generation antipsychotics, second-generation antipsychotics, mood stabilizers, and antianxiety medicines where inpatients were more frequently treated with these medications for all psychiatric diagnoses when compared with outpatients. On the contrary, in the case of antidepressant treatment, an opposite trend was observed with more number of treated outpatients in comparison to inpatients. Among elderly patients, 75.9% received antipsychotics, mainly second-generation formulations (67.2%), whereas only 41% received antidepressants and 13.8% received mood stabilizers.ConclusionBased upon the present study data, it is concluded that among all the psychotropic medications, antipsychotics were heavily used and the frequency was found to be significantly high in the case of inpatients compared with outpatients. Such a practice may lead to multiple negative consequences among the Saudi psychiatric patient population. Further, extensive use of sodium valproate in the case of bipolar disorder, and also among females either in childbearing age or during pregnancy is also the cause of concern and warrants logical use. Overall, this study may help in assessing the burden of psychiatric illness within specific patient demographics and might be effectively used to strategically plan health resources allocation, generate new treatment hypothesis, or be used as a source of evidence that could f...

Evaluation of psychotropic medications use among elderly with psychiatric disorders in Saudi Arabia

“…We found only 1.2% of the elderly mentally ill patients prescribed with paroxetine, a first-line SSRI. Our finding concurs with the report of Alosaimi et al that 1.8% inpatients and 4% outpatients in Saudi Arabia were prescribed paroxetine ( Alosaimi et al, 2016 ). However, the prescription pattern in our setting contrasts with the findings of Bhattacharjee et al reporting the extensive use of paroxetine ( Bhattacharjee et al, 2019 ).…”

Prevalence and determinants of physical activity in a mixed sample of psychiatric patients in Saudi Arabia

“…However, the antianxiety medications that were mainly used to treat patients with primary bipolar disorders were the only medications that retained the positive correlation with physical activity after adjusting for demographic and clinical characteristics. 44 Additionally, the antidepressants used in the current study, particularly tricyclic antidepressants, are associated with metabolic syndrome, which is traditionally associated with a lower physical activity profile. 45 , 46 However, the current findings should be interpreted with caution for several reasons.…”

Negative Impacts of Psychiatric Medications on Oral Health: A Literature Review

“…In SA, the prevalence of OCD was reported to be 3.4% to 23.1% [ 23 - 25 ]. Another cross-sectional study found that OCD affected 1.1% of inpatients (Total=443) and 3.3% of outpatients (Total=762) [ 26 ]. The difference in the prevalence of OCD in SA is affected by the regions in which SA studies are conducted and the differences in tools used to assess the prevalence of OCD.…”