ABSTRACT
Background: Schizophrenia is a chronic and debilitating psychiatric illness affecting around 0.3-0.7% of people at some point in their life. The rate of schizophrenia and related disorders is affected by some environmental factors and social variables. Therefore, pharmacoepidemiological survey of patients suffering from schizophrenia was carried out to analyze the sociodemographic profile and drug prescribing pattern. Methods: A prospective observational study was conducted in psychiatry OPD of a tertiary care hospital for nine months. Diagnosis of schizophrenia was made according to DSM IV-TR criteria. Prescriptions were analyzed for socio demographic details, distribution of subsets of disease and psychotropic drugs prescribed. Results: Amongst 196 cases analyzed, 55.61% were males, 69.9% were below 40 years, 52.04% unmarried, 61.22% belonged to low income group, 82.14% unemployed and 58.16% came from urban locality. Paranoid schizophrenia (79.59%) was the most common diagnosis and a total of 402 psychotropic drugs were prescribed. Average number of psychotropic drugs per prescription was 2.05. Atypical antipsychotics (80.09%) were prescribed more commonly than typical antipsychotics; olanzapine (42.48%) was the commonest antipsychotic drug followed by risperidone (21.68%), haloperidol (19.91%), quetiapine (7.96%), aripiprazole (4.42%) and clozapine (3.54%). As an adjunctive treatment escitalopram, clonazepam and carbamazepine were the commonly prescribed antidepressant, anxiolytic and antimanic agent respectively. Conclusion: Low socioeconomic status, unemployment, urban locality and living alone are the sociodemographic factors associated with schizophrenia. The treatment pattern observed correlates with the changing trends in the treatment of schizophrenia world over.
ABSTRACT
Background: The burden of illness resulting from psychiatric and behavioral disorders is enormous; although, it remains grossly under represented by conventional public health statistics, which focus on mortality rather than the morbidity or dysfunction. Therefore, the study was carried out to find out morbidity pattern of psychiatric diseases and prescribing trends of psychotropic drugs. Methods: A prospective observational study was conducted in psychiatry out-patient department of a tertiary care hospital for 3 months. Diagnosis was made according to ICD-10 criteria. Prescription pattern was analyzed using World Health Organization (WHO) drug indicators. Results: Of 520 patients analyzed, 52.31% were males and 47.69% were females, 72.31% were <45 years. Depression 42.88%, schizophrenia 23.08%, bipolar mood disorders 17.88%, and anxiety 9.04% accounted for 92.88% of cases. Among the total of 1092 psychotropic drugs prescribed, 1056 (96.7%) were oral formulations. Average number of psychotropic drugs per prescription was 2.1 ± 0.8. 20.58% of the prescriptions contained fixed dose combinations. About 28.75% drugs were prescribed by generic name. Utilization from the WHO and National essential medical list were 28.57% and 38.64%, respectively. The prescribing frequency of anxiolytics, anti-depressants, anti-psychotics, anti-cholinergics, and anti-mania drugs was 30.04% (328/1092), 25.46% (278/1092), 25.37% (277/1092), 11.54% (126/1092), and 7.6% (83/1092), respectively. Clonazepam, olanzapine, escitalopram, carbamazepine and trihexyphenidyl were the most commonly prescribed benzodiazepines (BZD), antipsychotic, antidepressants, mood stabilizer and anti-cholinergics, respectively. Conclusion: Utilization pattern of the psychotropic drugs were in accordance to the recommendations of various treatment guidelines. BZD were the most commonly prescribed psychotropic drugs.