Recent scenario on psychotropic drug usage pattern among patients attending psychiatric outpatient department of a tertiary care teaching hospital in Nepal

Vijay Raj Kaul, Mirza Atif Beg, Shaktibala Dutta, Shalu Bawa, Nand Kishore Singh, Sri Hari Dutta


Background: Due to increasing burden of psychiatric illnesses, it is essential to study the psychotropic drug utilization pattern in actual clinical practice. The objective of the study was to study the psychotropic drug usage pattern among patients attending psychiatric OPD of a tertiary care teaching hospital in Nepal.

Methods: This observational retrospective study was conducted in Nepal Gunj Medical College, Nepal for a period of 6 months from January 2016 to June 2016. A total of 282 prescriptions from Psychiatric OPD were analysed for drug usage pattern. Prescriptions containing at least one psychotropic drug were included. Data was measured for number and percentage of prescriptions or drugs, using selected World Health Organization (WHO) drug use indicators.

Results: A total of 282 prescriptions from Psychiatric OPD were analysed. Patients had a mean age of 35.01±1.17 years. Male and Female %age was 41.49% and 58.51% respectively. Majority of the patients (47.52%) were in 31-45 years age group. 70.57% patients were literate. Depression was the leading psychiatric illness seen in 144 (51.06%) patients followed by Anxiety disorders which were seen in 60 (21.28%) patients. A total of 2463 drugs were prescribed which included 591 (23.99%) antipsychotic drugs followed by 462 (18.76%) antidepressants, 390 (15.83%) antiepileptics, 312 (12.67%) supplements, 276 (11.21%) antianxiety, 171 (6.94%) antacids, 165 (6.7%) anticholinergics, 96 (3.9%) drugs in miscellaneous category. Drugs prescribed per prescription were 8.73 and psychotropic drugs per prescription were 6.09. Number of oral and injectable drugs were 2313 (93.91%) and 150 (6.09%) respectively. 87 fixed dose combinations (FDCs) of psychotropic drugs were prescribed. 903 (36.66%) drugs were prescribed from WHO’s 18th List of Essential Medicines.

Conclusions: Depression was the most common psychiatric illness and antipsychotics were the most commonly prescribed medicines in psychiatry OPD. Majority of the prescriptions revealed polypharmacy.


Drug utilization pattern, Psychotropic drugs, Polypharmacy, WHO drug use indicators

Full Text:



Murthy R. Mental Health Programme in the 11th five year plan. The Indian Journal of Medical Research. 2007;125:707-12.

Sharma P, Das S, Deshpande S. An estimate of the monthly cost of two major mental disorders in an Indian metropolis. Indian J Psychiatry. 2006;48:143-48.

Rode SB, Rajesh KA, Harsh VS, Umesh S. A study on drug prescribing pattern in psychiatry out-patient department from a tertiary care teaching hospital. Int J Basic Clin Pharmacol. 2014;3(3):517-22.

Costa J, Rosa MM, Ferreira JJ, Sampaio C, Vaz Carneiro A. Cardiac effects of acute poisoning with tricyclic antidepressants: systematic review of the literature. Part I. Rev Port Cardiol. 2001;20(6):671-78.

Moore S, Jaime LK, Maharajh H, Ramtahal I, Reid S, Ramsewak FS, et al. The prescribing of psychotropic drugs in mental health services in Trinidad. Rev Panam Salud Publica. 2002;12(3):207-14.

Davidson JR, Feltner DE, Dugar A. Management of generalized anxiety disorder in primary care: identifying the challenges and unmet needs. Prim Care Companion J Clin Psychiatry. 2010;12(2).

WHO. Drugs and Therapeutics Committees - A Practical Guide. Geneva: World Health Organization; 2003.

Dutta SB, Beg MA, Kaul V, Dutta S, Dhasmana DC. Psychotropic drug utilization study in Psychiatric OPD of a Tertiary care teaching hospital in Dehradun, Uttarakhand. Journal of Advance Researches in Biological Sciences. 2013;5(4):386-91.

Jorm A, Christensen H, Griffiths K. Changes in depression awareness and attitudes in Australia: the impact of beyond blue: the national depression initiative. Australian and New Zealand. Journal of Psychiatry. 2006;40:42-6.

Thakkar et al. A Drug Utilization Study of Psychotropic Drugs Prescribed in the Psychiatry Outpatient Department of a Tertiary Care Hospital. Journal of Clinical and Diagnostic Research. 2013;7(12):2759-64.

Patel V. Gender in Mental Health Research. Department of Gender, Women and Health Family and Community Health. World Health Organization. 2005.

Mohammed P, Mohamed E, Rajan S, Kumar K. Gender and mental health in Kerala Institute of Social Studies Trust. 2002.

Earls F. Sex differences in psychiatric disorders: origins and developmental influences. Psychiatric developments. 1987;5(1):1-23.

Piparva KG, Parmar DM, Singh AP, Gajera MV, Trivedi HR. Indian J Psychol Med. 2011;33(1):54-8.

Ahmed T, Sharma S, Ali S, Sachdev D, Sharma R, Jaiswal M. Drug utilization pattern in psychiatry outdoor patients at tertiary care teaching hospital of Bastar region. IJPR. 2015;5(4):98-103.

Wright BM, Eiland EH 3rd, Lorenz R. Augmentation with atypical antipsychotics for depression: a review of evidence-based support from the medical literature. Pharmacotherapy. 2013;33(3):344-59.

Komossa K, Depping AM, Gaudchau A, Kissling W, Leucht S. Second-generation antipsychotics for major depressive disorder and dysthymia. Cochrane Database Syst Rev. 2010; 8(12):CD008121.

Dhasmana DC, Rawat Y, Mishra KC. What is so atypical about atypical antipsychotic? Indian J Pharmacol. 2003;35:322-4.

Avanthi E, Somashekar HE, Kumar P, Sushma HK, Sudarshan CY et al. Prescribing pattern of antidepressants in psychiatric unit of a tertiary care hospital. Int J Basic Clin Pharmacol. 2014;3(4):667-70.

Dutta SB, Dhasmana DC, Bhardwaj R. Psychotropic Drug Utilization Pattern among Schizophrenics. Indian J Psychiatry. 2004;46(4):381-2.