Psychotropic drugs in low-income countries

Dharmawardene, Vajira; Menkes, David B.

doi:10.1016/s2215-0366(14)70372-4

Cited by 5 publications

(5 citation statements)

References 12 publications

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“…This indicates that if bonuses and incentives could be regulated and misuse of the drug is controlled, then the current price of psychotropic drugs could be reduced. Cost-effective strategies such as an emphasis on prescribing generic names and quality monitoring from an independent authority [ 20 ] could be helpful in ensuring availability of high quality drugs at affordable prices which could ultimately facilitate the roll out of the mhGAP intervention in primary health care. Secondly, for the mhGAP to be adequately rolled out in community settings, there is a need to revise the current psychotropic drug prescribing authority, from medical officers to the primary health care workers.…”

Section: Discussionmentioning

confidence: 99%

Psychotropic drugs in Nepal: perceptions on use and supply chain management

et al. 2018

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BackgroundPsychotropic drugs play an important role in the treatment of mental, neurological and substance use disorders. Despite the advancement of the use of psycho-pharmaceuticals in the developed countries, the psychotropic drug production and supply chain management in low- and middle- income countries are still poorly developed. This study aims to explore the perceptions of stakeholders involved in all stages of the psychotropic drug supply chain about the need, quality, availability and effectiveness of psychotropic drugs, as well as barriers to their supply chain management.The study was conducted among 65 respondents from the Kathmandu, Chitwan and Pyuthan districts, grouped into four categories: producers, promoters and distributors (N = 22), policy makers and government actors (N = 8), service providers (N = 21) and service users/family members (N = 14).ResultsThe respondents reported that psychotropic drugs, despite having side effects, are 1) needed, 2) available in major regional centers and 3) are effective for treating mental health problems. The stigma associated with mental illness, however, forces patients and family members to hide their use of psychotropic drugs. The study found that the process of psychotropic drug supply chain management is similar to other general drugs, with the exceptions of strict pre-approval process, quantity restriction (for production and import), and mandatory record keeping. Despite these regulatory provisions, respondents believed that the misuse of psychotropic drugs is widespread and companies are providing incentives to prescribers and retailers to retain their brand in the market.ConclusionsThe production and supply chain management of psychotropic drugs is influenced by the vested interests of pharmaceutical companies, prescribers and pharmacists. In the context of the government of Nepal’s policy of integrating mental health into primary health care and increased consumption of psychotropic drugs in Nepal, there is a need for massive education and awareness as well as strict monitoring and supervision to avoid the misuse of psychotropic drugs.Electronic supplementary materialThe online version of this article (10.1186/s12992-018-0322-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Psychotropic drugs in Nepal: perceptions on use and supply chain management

et al. 2018

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“…These findings are consistent with overseas studies 14,15 and may also have implications for drug-purchasing policies in low-income countries. 16…”

Section: Discussionmentioning

confidence: 99%

“…These findings are consistent with overseas studies 14,15 and may also have implications for drug-purchasing policies in low-income countries. 16 Clozapine was associated with a reduced rate of hospitalisation, despite its use in treatment-resistant patients, 17 and also longer readmissions when these were necessary. Clozapine has been demonstrated superior in reducing positive and negative symptoms, so can be associated with improvement in quality of life.…”

Section: Discharge Variables Hazard Ratio (95% Ci) For Rehospitalisatmentioning

confidence: 99%

Correlates of rehospitalisation in schizophrenia

Dey

Menkes

Obertová

et al. 2016

Australas Psychiatry

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“…It is the drug that established the monoamine theory of depressive disorder 4 and field of pharmacotherapy for panic disorder. 5 Despite several newer agents being more commonly available and prescribed, 6 imipramine remains an efficacious agent for treatment of panic disorder and depressive illness.…”

Section: Stigma Imipramine and Inequity In Health Vajira Dharmawardenementioning

confidence: 99%