ABSTRACT
BACKGROUND: There is a lack of information on the clinical and sociodemographic correlates of prescription of psychotropics by psychiatrists. AIM AND OBJECTIVE: This study aimed to evaluate the relationship of prescription patterns with various clinical and sociodemographic variables. METHODOLOGY: Data of prescription patterns, psychiatric diagnosis, sociodemographic variables, and comorbid physical illnesses were collected for 4480 patients, across 11 centers. RESULTS: Females are more often prescribed escitalopram, sertraline, amitriptyline, amisulpride, nonlithium mood stabilizers, and benzodiazepines, whereas males are more often prescribed fluoxetine, olanzapine, two antipsychotics concurrently, typical antipsychotics, valproate, lithium, and more than one benzodiazepine. Elderly (>65 years) participants are more often prescribed sertraline when compared to adolescents. In addition, elderly more often receive quetiapine and less often are prescribed benzodiazepines. Those with comorbid neurological disorders are commonly prescribed antipsychotics, amitriptyline, and more than one antidepressant and are less commonly prescribed lithium, combination of two mood stabilizers, and benzodiazepines. Those with cardiac ailments are more commonly prescribed sertraline, quetiapine, and lithium and less frequently prescribed amitriptyline, fluoxetine, olanzapine, risperidone, and typical antipsychotics. Those with diabetes mellitus more often received escitalopram and quetiapine. Presence of more than one psychiatric diagnosis was associated with the use of more number of medications. Further, diagnosis of affective disorders was associated with the use of a higher number of medications. CONCLUSION: Findings of the present study suggest that sociodemographic variables and physical and psychiatric comorbidity influence the prescription patterns of psychotropics.
ABSTRACT
BACKGROUND: There is a lack of national level data from India on prescription of psychotropics by psychiatrists. AIM AND OBJECTIVE: This study aimed to assess the first prescription handed over to the psychiatrically ill patients whenever they contact a psychiatrist. MATERIALS AND METHODS: Data were collected across 11 centers. Psychiatric diagnosis was made as per the International Classification of Diseases Classification of Mental and Behavioural Disorders 10(th) edition criteria based on Mini International Neuropsychiatric Interview, and the data of psychotropic prescriptions was collected. RESULTS: Study included 4480 patients, slightly more than half of the subjects were of male (54.8%) and most of the participants were married (71.8%). Half of the participants were from the urban background, and about half (46.9%) were educated up to or beyond high school. The most common diagnostic category was that of affective disorders (54.3%), followed by Neurotic, stress-related and somatoform disorders (22.2%) and psychotic disorders (19.1%). Other diagnostic categories formed a very small proportion of the study participants. Among the antidepressants, most commonly prescribed antidepressant included escitalopram followed by sertraline. Escitalopram was the most common antidepressant across 7 out of 11 centers and second most common in three centers. Among the antipsychotics, the most commonly prescribed antipsychotic was olanzapine followed by risperidone. Olanzapine was the most commonly prescribed antipsychotic across 6 out of 11 centers and second most common antipsychotic across rest of the centers. Among the mood stabilizers valproate was prescribed more often, and it was the most commonly prescribed mood stabilizer in 8 out of 11 centers. Clonazepam was prescribed as anxiolytic about 5 times more commonly than lorazepam. Clonazepam was the most common benzodiazepine prescribed in 6 out of the 11 centers. Rate of polypharmacy was low. CONCLUSION: Escitalopram is the most commonly prescribed antidepressant, olanzapine is the most commonly prescribed antipsychotic and clonazepam is most commonly prescribed benzodiazepine. There are very few variations in prescription patterns across various centers.
