A PROSPECTIVE STUDY ON DRUG UTILIZATION PATTERN OF ANTIDEPRESSANTS IN NON-PSYCHIATRIC DEPARTMENTS IN A TERTIARY CARE TEACHING HOSPITAL
Keywords:Antidepressants, Depression, Amitriptyline, Alprazolam, Tricyclic antidepressants, Selective serotonin reuptake inhibitors
Objective: The aim of this study is to evaluate the pattern of prescription and utilization of antidepressants (ADs) for various non-psychiatric indications in department of general medicine, cardiology, surgery, gynecology, and orthopaedic of a tertiary care teaching hospital.
Methods: A prospective cross-sectional unicentric drug utilization study of inpatients was carried out in a 450 bedded tertiary care hospital. The study included 200 subjects admitted for both psychiatric and non-psychiatric illness. Pediatric patients and those with a length of stay <48 h were excluded from the study.
Results: Prescriptions of 200 patients were studied in which 55% were males and 45% were females. The most widely prescribed drug is alprazolam comprising 50% of the total drug consumption and is followed by clonazepam (19.5%), amitriptyline (13.5%), diazepam (9.5%), escitalopram (3.5%), lorazepam (3%), and zolpidem (0.5%). About 36% of the drugs were prescribed in the general medicine department, and 27.5% of the prescriptions were from the cardiology department. Prescriptions from surgery, orthopedics, and gynecology were 16%, 11.5%, and 9% of the total, respectively.
Conclusion: ADs were found to be potentially useful for non-psychiatric indications such as peripheral and diabetic neuropathy, gastroenterological conditions, and urological conditions. No benefit was observed in insomnia and musculoskeletal conditions except for fibromyalgia. ADs were also found to improve the treatment outcome and quality of life of patients having comorbid psychiatric conditions being treated for non-psychiatric disorders.
Gasquet I, Nègre-Pagès L, Fourrier A, Nachbaur G, El-Hasnaoui A, Kovess V, et al. Psychotropic drug use and mental psychiatric disorders in France; Results of the general population ESEMeD/MHEDEA 2000 epidemiological study. Encephale 2005;31:195-206.
Olfson M, Marcus SC. National patterns in antidepressant medication treatment. Arch Gen Psychiatry 2009;66:848-56.
Ventes de Médicaments aux Officineset aux Hôpitaux en France: Chiffresclés 2010. [Sales of Medicines to Pharmacies and Hospitals in France: Key Figures 2010]. Rapport D’Expertise.
Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, et al. Psychotropic drug utilization in Europe: Results from the European study of the epidemiology of mental disorders (ESEMeD) project. Acta Psychiatr Scand Suppl 2004;109:55-64.
Grolleau A, Cougnard A, Bégaud B, Verdoux H. Psychotropic drug use and correspondence with psychiatric diagnoses in the mental health in the general population survey. Encephale 2008;34:352-9.
Piek E, van der Meer K, Hoogendijk WJ, Penninx BW, Nolen WA. Most antidepressant use in primary care is justified; Results of the Netherlands study of depression and anxiety. PLoS One 2011;6:e14784.
Gopinath S, Rajalingam B, Sriram S, Vijayakumar S. An individual based study of the geriatric population: A polypharmacy. Int J Pharm Pharm Sci 2013;3:63-6.
Arroll B, Elley CR, Fishman T, Goodyear-Smith FA, Kenealy T, Blashki G, et al. Antidepressants versus placebo for depression in primary care. Cochrane Database Syst Rev 2009;3:CD007954.
Stewart JA, Deliyannides DA, Hellerstein DJ, McGrath PJ, Stewart JW. Can people with nonsevere major depression benefit from antidepressant medication? J Clin Psychiatry 2012;73:518-25.
Mojtabai R, Olfson M. Proportion of antidepressants prescribed without a psychiatric diagnosis is growing. Health Aff (Millwood) 2011;30:1434-42.
Viswanathan N, Gandhi IS, Shashindran CH, Adithan C. Drug utilisation study of antimicrobial agents. Indian J Med Res 1981;74:772-8.
Mercier A, Auger-Aubin I, Lebeau JP, Schuers M, Boulet P, Hermil JL, et al. Evidence of prescription of antidepressants for non-psychiatric conditions in primary care: An analysis of guidelines and systematic reviews. BMC Fam Pract 2013;14:55.
Morgan V, Pickens D, Gautam S, Kessler R, Mertz H. Amitriptyline reduces rectal pain related activation of the anterior cingulate cortex in patients with irritable bowel syndrome. Gut 2005;54:601-7.
Häuser W, Bernardy K, Uçeyler N, Sommer C. Treatment of fibromyalgia syndrome with antidepressants: A meta-analysis. JAMA 2009;301:198-209.
Jena SS, Jena M, Patro N, Mishra S, Panda M, Dash M. Patterns of prescription and ADR monitoring of drugs in the management of neuropathic pain in a tertiary care teaching hospital. Int J Pharm Pharm Sci 2014;6:246-51.
Dharmshaktu P, Tayal V, Kalra BS. Efficacy of antidepressants as analgesics: A review. J Clin Pharmacol 2012;52:6-17.
Yılmaz B, Kömür B, Aktaş E, Sonnur Yılmaz F, Çopuroğlu C, Özcan M, et al. Impact of alprazolam on comorbid pain and knee functions in total knee arthroplasty patients diagnosed with anxiety and depression. Open Orthop J 2015;9:530-5.
Grover S, Biswas P, Bhateja G, Kulhara P. Escitalopram-associated hyponatremia. Psychiatry Clin Neurosci 2007;61:132-3.
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