Trends in the prescribing of antipsychotic medicines in Pakistan: implications for the future

Mahmood, Sajid; Hussain, Shahzad; Rehman, Taufeeq ur; Barbui, Corrado; Kurdi, Amanj; Godman, Brian

doi:10.1080/03007995.2018.1513834

Cited by 6 publications

(15 citation statements)

References 90 publications

(100 reference statements)

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“…With respect to stigma, in Botswana patients with mental disorders can often be seen as untrustworthy and cognitively impaired; consequently, they can be discriminated against in their working environment [53]. Domestic violence and issues of stigma are also reported among patients with mental disorders in Pakistan [54] and in Tunisia, there is also still a considerable social stigma associated with severe mental illness; however, less for patients with bipolar disorders than schizophrenia [12]. These barriers and threats to appropriate diagnosis and management of mental disorders need to be addressed to improve future care in LMICS [8].…”

Section: Generalmentioning

confidence: 99%

“…• These issues adversely affect access to appropriate care in Pakistan [54,179], exacerbated by increasing unemployment, disruptions in social norms and a high percentage of the population living below the poverty level [54,178,180].…”

Section: Pakistanmentioning

confidence: 99%

“…• Despite concerns, CPGs are being followed in Pakistan for the management of BD including the prescribing of lithium, anticonvulsants, antidepressants, and anti-psychotics [54].…”

Section: Pakistanmentioning

confidence: 99%

“…In addition, most GPs had not received any recent medical education about mental disorders, with serious gaps in GPs' knowledge about the management of mental disorders having serious implications for the rational use of psychotropic medications [42]. • Other challenges for the appropriate management of patients with BD include a lack of time with physicians and patients' financial constraints [54,213].…”

Section: Pakistanmentioning

confidence: 99%

See 3 more Smart Citations

Pharmacotherapeutic interventions for bipolar disorder type II: addressing multiple symptoms and approaches with a particular emphasis on strategies in lower and middle-income countries

Godman

Grobler

Van-De-Lisle

et al. 2019

Expert Opinion on Pharmacotherapy

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Introduction: Appropriately managing mental disorders is a growing priority across countries in view of the impact on morbidity and mortality. This includes patients with bipolar disorders (BD). Management of BD is a concern as this is a complex disease with often misdiagnosis, which is a major issue in lower and middleincome countries (LMICs) with typically a limited number of trained personnel and resources. This needs to be addressed. Areas covered: Medicines are the cornerstone of managing patients with Bipolar II across countries including LMICs. The choice of medicines, especially antipsychotics, is important in LMICs with high rates of diabetes and HIV. However, care is currently compromised in LMICs by issues such as the stigma, cultural beliefs, a limited number of trained professionals and high patient co-payments. Expert opinion: Encouragingly, some LMICs have introduced guidelines for patients with BD; however, this is very variable. Strategies for the future include addressing the lack of national guidelines for patients with BD, improving resources for mental disorders including personnel, improving medicine availability and patients' rights, and monitoring prescribing against agreed guidelines. A number of strategies have been identified to improve the treatment of patients with Bipolar II in LMICs, and will be followed up.

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Section: Generalmentioning

confidence: 99%

Section: Pakistanmentioning

confidence: 99%

“…• Despite concerns, CPGs are being followed in Pakistan for the management of BD including the prescribing of lithium, anticonvulsants, antidepressants, and anti-psychotics [54].…”

Section: Pakistanmentioning

confidence: 99%

Section: Pakistanmentioning

confidence: 99%

See 2 more Smart Citations

Pharmacotherapeutic interventions for bipolar disorder type II: addressing multiple symptoms and approaches with a particular emphasis on strategies in lower and middle-income countries

Godman

Grobler

Van-De-Lisle

et al. 2019

Expert Opinion on Pharmacotherapy

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“…Olanzapine and risperidone were the most prescribed antipsychotics. 2 The use of atypical antipsychotics is associated with the severe disruption in whole blood glucose and lipid metabolism. This partially occurs through central nervous system and result in impaired insulin action through brain.…”

Section: Introductionmentioning

confidence: 99%

Effect of atypical antipsychotics on blood glucose levels and HbA1c in patients of schizophrenia and bipolar disorder.

Bughio¹,

Ansari²,

Kumar

et al. 2021

TPMJ

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Objectives: To evaluate the effect of atypical antipsychotics on serum glucose levels and HbA1C in patients of schizophrenia and bipolar disorder. Study Design: Quasi-experimental study. Setting: Department of Neurology and Sir C. J Institute of Psychiatry LUMHS Jamshoro/Hyderabad. Period: Dec 2018-Dec 2019. Material & Methods: Total 360 participants of age more than 15 years of either gender presenting with psychiatric illness i.e. schizophrenia and bipolar disorder and prescribed same brand of antipsychotic drugs were included in the study. Fasting blood glucose (FBS), random blood glucose (RBS) and glycosylated hemoglobin (HbA1c) were measured at baseline and 6th months after treatment with atypical antipsychotic agents. SPSS version 23 was used to analyze data. Results: A total of 360 patients were enrolled in the study duration, among them 338 patients were followed up till 6 months, while 22 patients were lost to follow up. The mean age of the study sample was reported as 39.33±8.83 years. At baseline mean FBS, RBS and HbA1c were reported as 92.52±9 mg/dl, 143.21±14.91, 5.83±0.37 which significantly increase after treatment with antipsychotics at 6 months (p<0.05). About 23.6% developed diabetes mellitus and 21.3% developed hyperglycemia at the end of 6 months. Conclusion: Non-diabetic treatment naïve schizophrenia and bipolar disorders patients have higher chances developing side-effects on the glucose regulations after initiation of antipsychotic therapy. Overall, the early identification and diagnosis of antipsychotic-induced diabetes mellitus and hyperglycemia requires proper evaluation, reporting, and physician and patient awareness.

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Prescription analysis and cost of antidepressant drugs in major depressive disorder outpatients at the tertiary care hospital of Pakistan: a prospective approach

Kamran

Khan

Saqlain

et al. 2021

Expert Review of Pharmacoeconomics & Outcomes Research

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Trends in the prescribing of antipsychotic medicines in Pakistan: implications for the future

Cited by 6 publications

References 90 publications

Pharmacotherapeutic interventions for bipolar disorder type II: addressing multiple symptoms and approaches with a particular emphasis on strategies in lower and middle-income countries

Pharmacotherapeutic interventions for bipolar disorder type II: addressing multiple symptoms and approaches with a particular emphasis on strategies in lower and middle-income countries

Effect of atypical antipsychotics on blood glucose levels and HbA1c in patients of schizophrenia and bipolar disorder.

Prescription analysis and cost of antidepressant drugs in major depressive disorder outpatients at the tertiary care hospital of Pakistan: a prospective approach

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