Abstract
Background: Prescription pattern analysis forms an important part of drug utilization studies, that are helpful in the rational prescribing of drugs and also to reduce medication errors. In our country, the available data on the prescription pattern of drugs in psychiatric disorders is very limited. Hence in our study, we focus on the prescribing pattern of drugs in anxiety disorders, which is one of the most widespread psychiatric disorders.
Methodology: A prospective observational study was conducted over a period of one year (January 2018 to December 2018) by analyzing the prescription forms of 51 patients who were diagnosed with anxiety disorders in psychiatry outpatient department. This study was initiated after getting approval from institutional human ethics committee.
Results: Out of 51 prescriptions analyzed, generalized anxiety disorder (33.33%) was the most common anxiety disorder followed by panic anxiety disorder (23.52%). Majority of the patients belong to the age group of 36- 45 years(37.25%). Major proportion of the participants were males (52.94%). By assessing the prescription pattern as per WHO/INRUD drug use indicators, the average number of drugs per prescription was found to be 2.60. Benzodiazepines and selective serotonin reuptake inhibitors were the most common drug groups used to treat anxiety disorders.
Conclusion: Prescription pattern of drugs for anxiety disorders were rational and according to WHO guidelines. The age and morbidity distribution pattern of the study participants are similar to the outcome of many previous studies.
Keywords: Anxiety disorder, Generalized anxiety disorder, Prescription pattern, Clonazepam.
References
- Martin, Patrick. “The epidemiology of anxiety disorders: a review.” Dialogues in clinical neuroscience 5,3 (2003): 281-98.
- Dutta, Shakti B. et al. Study on drug usage pattern of anxiolytics in psychiatric department in a tertiary care teaching hospital at Dehradun, Uttarakhand, India. International Journal of Basic & Clinical Pharmacology, [S.l.], v. 6, n. 7, p. 1661-1665, june 2017
- Lewinsohn, P. M., Gotlib, I. H., Lewinsohn, M., Seeley, J. R., & Allen, N. B. . Gender differences in anxiety disorders and anxiety symptoms in adolescents. Journal of Abnormal Psychology:1998; 107(1), 109-117.
- Ansseau M1, Fischler B, Dierick M, Albert A: Socioeconomic correlates of generalized anxiety disorder and major depression in primary care: the GADIS II study (Generalized Anxiety and Depression Impact Survey II). Belgium:Pubmed: 2008
- Mwinyi J1, Pisanu C2, Castelao E: Anxiety Disorders are Associated with Low Socioeconomic Status in Women but Not in Men:Sweden:Pubmed:2017
- Reddy VM1, Chandrashekar CR: Prevalence of mental and behavioural disorders in India: a meta-analysis: Banglore: Pubmed:2008.
- Swathi V. S., Srinivasa Rao Y and Saritha M: Prescribing pattern of drugs in generalized anxiety disorder: a prospective study: Vishakapatnam: International journal of current advanced research: 2017.
- Kessler RC, Anthony JC, Blazer DG, et al. The US National Comorbidity Survey: overview and future directions. Pubmed: Epidemiol Psychiatr Soc 1997; 6: 4–16.
- Bijl RV, Ravelli A, van Zessen G. Prevalence of psychiatric disorder in the general population: results of The Netherlands Mental Health Survey and Incidence Study (NEMESIS). Soc Psychiatry Psychiatr Epidemiol :Pubmed: 1998; 33: 587–95.
- Dutta S, Beg M A, Kaul V: Psychotropic Drug Utilization Study In Psychiatric Opd Of A Tertiary Care Teaching Hospital In Dehradun, Uttarakhand: Journal Of Advance Researches In Biological Sciences: 2013.
- Ghosh S, Bhattacharyya S, Bhattacharya A. Medications for Anxiety: A Drug Utilization Study In Psychiatry.Burdwan: Journal of Drug Delivery & Therapeutics. 2013;3(4):79-84.
- Glenn A J ,William T:Psychoactive drug prescribing in the Tasmanian community: The medical journal of Australia:1992.
- Vandana G,Shifali M,Rashmi G: Drug Utilization Pattern of Psychotropic Drugs Prescribed in the Psychiatric Department of a Tertiary Care Government Hospital, Rajasthan:Ajmer: Journal of Dental and Medical Sciences:2016.
- Sonali B. R, Rajesh K. A.: A study on drug prescribing pattern in psychiatry out-patient department from a tertiary care teaching hospital: Bhopal: International Journal of Basic & Clinical Pharmacology: 2014.
- Shaktibala D, Mirza A B: Role of pharmaco-epidemiology in psychopharmacology: a study in psychiatric out-patient department of a tertiary care teaching hospital at Dehradun, Uttarakhand: International Journal of Basic & Clinical Pharmacology: 2014
- Piparva KG, Parmar DM: Drug Utilization Study of Psychotropic Drugs in Outdoor Patients in a Teaching Hospital:Gujarat: Indian Journal of Psychological Medicine: 2011.
- Zito JM, Safer DJ, Reis S, et al. Psychotropic Practice Patterns for Youth: A 10-Year Perspective. Arch Pediatr Adolesc Med.2003;157(1):17-25.
- Arvind K Y, Jitendra J: Evaluation of rationality of fixed-dose combinations prescribed in psychiatric patients: Rajasthan: National Journal of Physiology, Pharmacy and Pharmacology; 2015.
- Sandeep G, Ajit A: Indian Psychiatric Society multicentric study: Prescription patterns of psychotropics in India: Indian Journal of Psychiatry 56(3), Jul‑Sep 2014.
- Banerjee I, Roy B, Sathian B: Medications for Anxiety: A Drug utilization study in Psychiatry Inpatients from a Tertiary Care Centre of Western Nepal: Medications for anxiety: A Drug Utilization study in Psychiatry Inpatients Nepal Journal of Epidemiology 2011.
- Mark O; Marissa K; Michael S : Benzodiazepine Use In The United States: Jama Psychiatry; 2015.
- Lader, M., Bond, A., & James, D. . Clinical Comparison Of Anxiolytic Drug Therapy. : Uk :Psychological Medicine: 1974.
- Math SB, Chandrashekar CR, Bhugra D. Psychiatric epidemiology in India. The Indian journal of Medical research 2007 Sep; 126(3): 183–92.
- Murthy R. Mental Health Programme in the 11th five year plan. The Indian Journal of Medical Research. 2007 Jun; 11: 707–12.
- Wittchen HU. Generalized anxiety disorder: prevalence, burden, and cost to society: Pubmed: Depress Anxiety: 2002; 16(4):162–71.
- Kaplan and sadock’s: synopsis of psychiatry; behavioural sciences/ clinical psychiatry: 11th edition: chapter 8- anxiety disorders : 388.
- Fixed Dose Combinations Approved By DCG (I) Since 1961 Till July,2014. Available at :http://www.cdsco.nic.in.
Corresponding Author
Nirmala P.
Professor and Head, Department of Pharmacology, Rajah Muthiah Medical College, Annamalai University, Chidambaram, India