Psychotropic drug utilization in psychiatric outpatient department of a tertiary care teaching hospital in India

Mohanraj Rathinavelu Mudhaliar, Ishrar Shaik Mohammad Ghouse, Priyanka Sadubugga, Swaroop Reddy Narala, Vidyasagar Chinnakotla, Prabhakar Yendluri


Background: Although psychotropic medications have had a remarkable impact on psychiatric practice that legitimately can be called revolutionary, their utilization and consequences on real life effectiveness and safety in actual clinical practice need continuous study.

Methods: The current retrospective study of six months’ duration was designed to assess the utilization of antipsychotics and its prescribing pattern in a tertiary care hospital of south India, which included prescriptions of patients suffering from a psychiatric illness with at least one psychotropic drug of all ages and both sexes.

Results: Out of 150 cases reviewed, 46% were of schizophrenia, where male (60.67%) at higher incidence of psychiatric illness, and maximum patients were under the age group of 29-39 years (54.67%). In present study of 355 prescribed drugs 72.67% were psychotropic medications. As per World Health Organization/International Network for Rational Use of Drugs (INRUD) drug use indicators average number of drugs per prescription (2.37%), average number of psychotropic drugs per prescription (1.72%), psychotropic drugs prescribed as Fixed Dose Combinations (FDCs) was 26.36%, and percentage of drugs prescribed by generic name (91.08%). In our study, 48.09% of psychotropic drugs were utilized in the treatment of schizophrenia, diazepam (17.06%) was the only psychotropic medication distributed in the management of all three observed psychiatric disorders and the study showed a higher utilization of psychotropic drugs as FDCs (25.98%) in the management of schizophrenia.

Conclusions: The study advocated an overall rational utilization of psychotropic drugs with a fewer deviations due to socio-economic status of patients and prescription practices of healthcare providers.



Drug utilization, INRUD, Prescribing pattern, Psychotropic medications, Retrospective study, WHO indicators

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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;48:143-8.

World Health Organization. The World Health Report 2001- Mental Health: New understanding, new hope. Geneva; 2001. Available from: http:// (cited 2012 Sep 5).

Math SB, Chandrashekar CR, Bhugra D. Psychiatric epidemiology in India. Indian J Med Res. 2007;126(3):183-92.

Murthy R. Mental Health Programme in the 11th five-year plan. Indian J Medl Res. 2007;11:707-12.

The ESEMeD/MHEDEA 2000 investigators. Psychotropic drug utilization in Europe: Results from the Europe Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand. 2004;109:55-64.

Baldessarini RJ, Tarazi FI. Pharmacotherapy of psychosis and mania. In: Hardman JG, Limbird LE, Gilman AG, eds. Goodman and Gilman's The Pharmacological basis of therapeutics. 11th ed. New York: McGraw-Hill; 2006:429-54.

WHO International Working Group for Drug Statistics Methodology. Introduction to drug utilization research. Geneva: WHO Collaborating Centre for Drug Utilization Research and Clinical Pharmacology; 2003. Available from: http:// (cited 2012 Nov 1).

Strom BL. Pharmacoepidemiology. 4th ed. England: John Wiley and Sons; 2005.

Brunton L, Lazo J, Parker K. Goodman and Gilman’s the pharmacological basis of therapeutics. 11th ed. McGraw-Hill publication; 2006:401-500.

Rode S, Salankar H, Verma P. Pharmacoepidemiological survey of schizophrenia in Central India. Int J Res Med Sci. 2014;2(3):1058-62.

Joel JJ, Shastry CS, Rao S. Cost-analysis of psychotropic drugs prescribed for the patients with schizophrenia in a university teaching hospital. Pharm Innov J. 2015;4(1):67-70.

Sonali B. Rode, Harsh V. Salankar, Pravin R. Verma. Antipsychotic drug prescribing pattern in tertiary care teaching hospital. EJPMR, 2015;2(5):369-78.

Paul PK, Konwar M, Das S. To study the prescribing pattern of antipsychotic drugs in a tertiary care hospital of Assam. Int J Pharm Pharm Sci. 2014;6(4):435-7.

Ghosh S, Bhattacharyya S, Dalai CK. Antipsychotic prescribing pattern in a tertiary care hospital of eastern India. J Drug Del Therap. 2013;3(4):38-42.

Thakkar KB, Jain MM, Billa G, Joshi A, Khobragade AA. A drug utilization study of psychotropic drugs prescribed in the psychiatry outpatient department of a tertiary care hospital. J Clin Diagn Res. 2013;7(12):2759-64.

Piparva KG, Parmar DM, Singh AP, Gajera MV, Trivedi HR. Drug utilization study of psychotropic drugs in outdoor patients in a teaching hospital. Indian journal of psychological medicine. 2011 J;33(1):54-8.

Lahon K, Shetty H, Paramel A, Sharma G. A retrospective drug utilization study of antidepressants in the psychiatric unit of a tertiary care hospital. J Clin Diagn Res. 2011;5(5):1069-75.

Mukherjee S, Sen S, Chatterjee S. Prescribing pattern of psychotropic medications in psychiatry outpatients at a tertiary care teaching hospital in India: a prospective cross-sectional study. Int J Hosl Res. 2014;3(3):113-22.

Swamy MK, Wagle L, Giri V. Drug utilisation pattern of psychotropic drugs in psychiatric outpatient department of rural tertiary care teaching hospital. Int J Pharm Sci Res. 2016;7(8):3497-08.

Carpenter WT Jr, Buchanan RW, Kirkpatrick B, Breier AF. Diazepam treatment of early signs of exacerbation in schizophrenia. Am J Psychiatry. 1999;156(2):299-303.

Lam RW, Kennedy SH, Grigoriadis S, McIntyre RS, Milev R, Ramasubbu R, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) Clinical guidelines for the management of major depressive disorder in adults.: III. Pharmacotherapy. J Affective Disorders. 2009;117:S26-43.