DRUG UTILISATION PATTERN OF PSYCHOTROPIC DRUGS IN PSYCHIATRIC OUTPATIENT DEPARTMENT OF RURAL TERTIARY CARE TEACHING HOSPITAL

Background: Psychiatric disorders are one of the major causes of morbidity. Development of newer drugs like selective serotonin reuptake inhibitors and atypical antipsychotics has altered the treatment paradigms. Objective: To study drug utilization pattern of psychotropic drugs in psychiatric outpatient department. Material and Methods: After ethical approval six month observational, prospective study was conducted at tertiary care hospital, South India. Prescriptions containing at least one psychotropic drugs were included. Data was measured for number and percentage of prescriptions or drugs and using selected World Health Organization (WHO) drug use indicators. Microsoft excel was used to summarize and graph pad instat was used for analysis of data as appropriate.(P < 0.05). Results: 101 prescription contained 187drugs (1.851±0.8 per prescription) where 67.33% of prescriptions had more than 2 psychotropic drugs introducing psychiatric polypharmacy. Selected WHO drug use indicators showed some potential problems in prescriptions which can be improved. Antidepressants (41.49%) were prescribed more followed by sedative/hypnotics (34.69%), antipsychotics (16.3%) and antimaniac drugs (7.4%). Among antidepressants, Sertraline was highly prescribed followed by Amitriptyline, Escitalopram and Mirtazepine. Clonazepam was frequently prescribed sedative/hypnotic. All antipsychotics were newer generation adjuncted with central anticholinergics; Risperidone being first choice. For mania, Valproic acid was frequently used. Among these drugs; frequently Clonazepam (24.48%) and infrequently Quetiapine (1.36%) were used. Conclusion: The trend of prescribing in psychiatry is shifted to newer drugs like selective serotonin reuptake inhibitors and atypical antipsychotics. There is evidence of practice of psychiatric polypharmacy. Results of WHO drug use indicators also showed need to improve prescribing habits to ensure rational use