Prescribing pattern of antidepressants in psychiatric unit of a tertiary care hospital
Keywords:Antidepressants, Drug utilization, Fluoxetine
Background: The objective was to study the prescribing pattern of antidepressants in psychiatric unit of a tertiary care hospital.
Methods: An observational study was carried out at psychiatry out-patient department (OPD). The data which were collected included information about age, gender, education, occupation, marital status and drug prescription included trade name, generic name, dosage, and frequency of 100 outpatients who attended the psychiatry OPD.
Results: Among 100 patients with major depression 66% were females and 34% were males. Depression was more commonly seen between patients with age group 21-40 years. Depression was more common among housewives (44%) and next was students (18%). Percentage of depression was more in educated people with (72%) than in uneducated with (28%). Depression was more commonly seen in married people with (77%) than in unmarried people (23%). Most commonly prescribed antidepressant as monotherapy was fluoxetine and as combination therapy was fluoxetine and escitalopram.
Conclusions: Depression is more commonly seen in married people predominantly in females and housewives. Fluoxetine is more commonly used followed by escitalopram. Selective serotonin reuptake inhibitors are preferred over other antidepressant because of their relative lesser side effects.
Revised Global Burden of Disease (GBD) 2002 Estimates. Geneva: World Health Organization; 2005: 667.
Ray S, Chogtu B. Prescribing trends in depression: a drug utilization study done at a tertiary healthcare centre. J Clin Diagn Res 2011;5(3):573-7.
Sadock B, Sadock V, Ruiz P, editors. Comprehensive Textbook of Psychiatry-Kaplan and Sadock’s. 9th Edition, Volume 1. Philadelphia, PA: Wolters Kluwer, Lippincott Williams and Wilkins; 2009: 923.
National Institute for Health and Clinical Excellence. Depression: the Treatment and Management of Depression in Adults (Update), 2009. Available from: http://www.guidance.nice.org.uk/CG90. [Last accessed on 2013 Aug].
Reddy MS. Depression: The disorder and the burden. Indian J Psychol Med 2010;32:1-2.
Sadock BJ, Sadock VA. Mood disorders. In: Sadock BJ, Sadock VA, editors. Kaplan and Sadock’s Concise Textbook of Psychiatry. 3rd Edition. New Delhi: Wolter Kluwer; 2008: 200-25.
Shelton RC, Lester N. SSRI’s and newer antidepressants. In: APA Textbook of Mood Disorders. Washington, DC: APA Press; 2006.
Tripathi KD. Antidepressant drugs. In: Tripathi KD, editor. Essentials of Medical Pharmacology. 6th Edition. New Delhi: Jaypee Brothers; 2008:446.
Uchida N, Chong MY, Tan CH, Nagai H, Tanaka M, Lee MS, et al. International study on antidepressant prescription pattern at 20 teaching hospitals and major psychiatric institutions in East Asia: analysis of 1898 cases from China, Japan, Korea, Singapore and Taiwan. Psychiatry Clin Neurosci. 2007;61(5):522-8.
Olfson M, Marcus SC, Pincus HA, Zito JM, Thompson JW, Zarin DA. Antidepressant prescribing practices of outpatient psychiatrists. Arch Gen Psychiatry. 1998;55:310-6.
Hemels ME, Koren G, Einarson TR. Increased use of antidepressants in Canada:1981-2000. Ann Pharmacother. 2002;36:1375-9.
Hansen DG, Søndergaard J, Vach W, Gram LF, Rosholm JU, Kragstrup J. Antidepressant drug use in general practice: inter-practice variation and association with practice characteristics. Eur J Clin Pharmacol. 2003;59(2):143-9.
Pirraglia PA, Stafford RS, Singer DE. Trends in Prescribing of Selective Serotonin Reuptake Inhibitors and Other Newer Antidepressant Agents in Adult Primary Care. Prim Care Companion J Clin Psychiatry. 2003;5(4):153-57.
National Collaborating Centre for Mental Health. National clinical practice guideline No 23 – Depression: management of depression in primary and secondary care. Leicester: British Psychological society and Royal College of Psychiatrists; 2004.
Fochtmann LJ, Gelenberg AJ. Guideline Watch: practice Guidelines for the Treatment of Patients with Major Depressive Disorder. 2nd Edition, Volume 3. Arlington, VA: American Psychiatric Association, Focus; 2005. p. 34-42.
Banerjee I, Roy B, Banerjee I, Sathian B, Mondol M, Saha A. Depression and its cure: a drug utilization study from a tertiary care centre of Western Nepal. Nepal J Epidemiol. 2011;1(5):144-52.
Katon W, Schulberg H. Epidemiology of depression in primary care. Gen Hosp Psychiatry. 1992;14(4):237-47.
Poongothai S, Pradeepa R, Ganesan A, Mohan V. Prevalence of depression in a large urban South Indian population – the Chennai Urban Rural Epidemiology Study (CURES-70). PLoS One 2009;4(9):e7185.
Mant A, Lansbury G, Bridges-Webb C. Trends in psychotropic drug prescribing in Australia. Med J Aust 1987;146(4):208-10.
González HM, Tarraf W, West BT, Chan D, Miranda PY, Leong FT. Research article: antidepressant use among Asians in the United States. Depress Anxiety 2010;27:46-55.
Chakos M, Lieberman J, Hoffman E, Bradford D, Sheitman B. Effectiveness of second-generation antipsychotics in patients with treatment-resistant schizophrenia: a review and meta-analysis of randomized trials. Am J Psychiatry 2001;158(4):518-26.
Ramesh MG, Sathian B, Shreevatsa BM, Bedanta R, Ramesh K, Budhachandra Y, et al. Gender variation of somatic symptoms of depression as possible indicators of its diagnosis and severity. J Clin Diagn Res 2010;4:3095-9. [Last cited on 2010 Oct 14].
Boehlke J. Housewives & Depression, Dec 2010. Available from: http://www.livestrong.com/article/138031housewives-depression/. [Last cited on 2011 Nov 15].
Murray ML, de Vries CS, Wong IC. A drug utilisation study of antidepressants in children and adolescents using the general practice research database. Arch Dis Child. 2004;89(12):1098-102.
Kafle KK, Prasad RR, Thapa BB. National List of Essential Medicine (Forth Revision Draft). Nepalese National Formulary. 2nd Edition. Kathmandu: 2010: 443.
Raut P. Drug utilization pattern of psychotropic drugs in Kasturba hospital [Dissertation]. Kasturba Medical College: Manipal University; 2006.
Bhattarai DD, Shrestha DA, Dixit H, Acharya LI, Kafle KK, Prasad RR, et al. National List of Essential Drugs. Nepalese National Formulary. 1st Edition. Kathmandu: Kanchan Printing Press; 1997: 125-9.