DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20175080

Pattern of antidepressant prescription at tertiary (mental hospital vs medical college) care centre of central India

V. S. Pal, Dheerendra Kumar Mishra, Pali Rastogi

Abstract


Background: Western literature full of extensively study the antidepressant prescription pattern at different settings. Recently in Indian context multicentre study and individual centers reported pattern of antidepressant uses for management of depression. With the time newer antidepressant approved, with better understanding of evidence based pathogenesis of illness influence the treatment patterns. Mental hospital setting is different that medical college setting at least for stigma related issue. The aim of the research work was to study the pattern of antidepressant prescription at mental hospital and medical college settings.

Methods: Cross-sectional assessments were done at mental hospital and medical college centers. Subjects diagnosed as depressive episode as per ICD 10, age >18 year included in study. Total 105 treatment seeking subject included in study from both centers Data was collected on socio-demographic characteristics, Clinical profile and prescribed medication.

Results: 49 subjects from mental hospital, 56 subjects from medical college included in study. Mean age of study sample 39.27±12.96 vs 37.49±14.90 years respectively at mental hospital and medical college centers. Escitalopram prescribed 83.7% subjects, 53.3 % subjects receive monotherapy. L methyl folate and atypical antipsychotics was most commonly adjunctive medication with antidepressants.

Conclusions: In sociodemographic differences subjects attending mental hospital belong to lower socioeconomic status compare to subject attending mental hospitals. There were no significant differences in prescription pattern of antidepressant medication for treatment of depressive episode. Escitalopram most commonly prescribed antidepressant and L methyl folate and atypical antipsychotics was most commonly used adjuvant with antidepressant medications.

 


Keywords


Antidepressant use pattern, Depression, Escitalopram, Mirtazepine, SSRI, SNRI

Full Text:

PDF

References


Bonari L, Pinto N, Ahn E, Einarson A, Steiner M, Koren G. Perinatal risks of untreated depression during pregnancy. Can J Psychiatr. 2004;49:726-35

Broadhead WE, Blazer DG, George LK, Tse CK. Depression, disability days, and days lost from work in a prospective epidemiologic survey. JAMA. 1990;264(19):2524-8.

Wisniewski SR, Fava M, Trivedi MH, Thase ME, Warden D, Niederehe G, et al. Acceptability of second-step treatments to depressed outpatients: a STAR* D report. Ame J Psychiatr. 2007;164(5):753-60.

Trivedi MH, Rush AJ, Wisniewski SR, Nierenberg AA, Warden D, Ritz L, et al. Evaluation of outcomes with citalopram for depression using measurement-based care in STAR* D: implications for clinical practice. Ame J Psych. 2006;163(1):28-40.

Bauer M, Monz BU, Montejo AL, Quail D, Dantchev N, Demyttenaere K, et al. Prescribing patterns of antidepressants in Europe: Results from the Factors Influencing Depression Endpoints Research (FINDER) study. Eur Psychiatr. 2008;23:66-73.

Kjosavik SR, Hunskaar S, Aarsland D, Ruths S. Initial prescription of antipsychotics and antidepressants in general practice and specialist care in Norway. Acta Psychiatr Scand. 2011;123:459-65.

Nakao M, Takeuchi T, Yano E. Prescription of benzodiazepines and antidepressants to outpatients attending a Japanese university hospital. Int J Clin Pharmacol Ther. 2007;45:30-5.

Chakrabarti S, Kulhara P. Patterns of antidepressant prescriptions: I acute phase treatments. Indian J Psychiatry. 2000;42:21-8.

Trivedi JK, Dhyani M, Sareen H, Yadav VS, Rai SB. Anti-depressant drug prescription pattern for depression at a tertiary health care center of Northern India. Med Pract Rev. 2010;1:16-8.

Grover S, Avasth A, Kalita K, Dalal PK, Rao GP, Chadda RK, et al. IPS multicentric study: Antidepressant prescription patterns. Indian J Psychiatr. 2013;55(1):41-5.

Lako IM, Taxis K, Bruggeman R, Knegtering H, Burger H, Wiersma D, et al. The course of depressive symptoms and prescribing patterns of antidepressants in schizophrenia in a one-year follow-up study. Eur Psychiatr. 2012;27:240-4.

Uchida N, Chong MY, Tan CH, Nagai H, Tanaka M, Lee MS, et al. International study on antidepressant prescription pattern at 20 teaching hospitals and major psychiatric institutions in East Asia: Analysis of 1898 cases from China, Japan, Korea, Singapore and Taiwan. Psychiatr Clin Neurosci. 2007;61:522-8.

Gelenberg AJ, Freeman MP, Markowitz JC, Rosenbaum JF, Thase ME, Trivedi MH, et al. Practice guideline for the treatment of patients with major depressive disorder third edition. Americ J Psychiatry. 2010;167(10):1.