A Drug Use Evaluation Study on Antidepressants in Psychiatric Patients at a Tertiary Care Teaching Hospital
Rajesh Hadia *
Department of Pharmacy, Sumandeep Vidyapeeth Deemed to be University, Vadodara-391760, Gujarat, India.
Bhumin Sanghani
Department of Pharmacy, Sumandeep Vidyapeeth Deemed to be University, Vadodara-391760, Gujarat, India.
Sushin Sajan
Department of Pharmacy, Sumandeep Vidyapeeth Deemed to be University, Vadodara-391760, Gujarat, India.
Tiji Mathew
Department of Pharmacy, Sumandeep Vidyapeeth Deemed to be University, Vadodara-391760, Gujarat, India.
Trupal Rathod
Department of Pharmacy Practice, Maliba Pharmacy College, Mahuva-Bardoli Road, Bardoli-394350, Gujarat, India.
Dhaval Joshi
Department of Pharmacy Practice, Maliba Pharmacy College, Mahuva-Bardoli Road, Bardoli-394350, Gujarat, India.
Rajesh Maheshwari
Department of Pharmacy, Sumandeep Vidyapeeth Deemed to be University, Vadodara-391760, Gujarat, India.
Sunil Baile
Department of Pharmacy, Sumandeep Vidyapeeth Deemed to be University, Vadodara-391760, Gujarat, India.
Sunil Kardani
Department of Pharmacy, Sumandeep Vidyapeeth Deemed to be University, Vadodara-391760, Gujarat, India.
Hemraj Singh Rajput
Department of Pharmacy, Sumandeep Vidyapeeth Deemed to be University, Vadodara-391760, Gujarat, India.
*Author to whom correspondence should be addressed.
Abstract
Background: The pattern of prescribing Antidepressants to patients has been varying worldwide.
Objective: We aim to observe the prescribing pattern of antidepressants as well as assess its various outcomes in patients, the rationality of the prescriptions, and the prevalence of antidepressant usage.
Methodology: A prospective observational study of a total of 56 subjects receiving antidepressants was performed at the Psychiatry. They were screened for their various outcomes on using antidepressants. The written form of the medical record sheet was used to preserve the patient's Data. Prescription pattern, treatment chart, abnormal vitals were noted. Morisky's adherence scale was used to assess the adherence of patients to prescribed drugs. Hamilton depression rating scale was used to measure the patient's depressive stage. They were screened for possible ADRs. The causality and severity assessment of the observed ADRs was done by the WHO-UMC scale and Hartwig-Seigel scale respectively. Statistical analysis was done for all relevant data.
Results: In our study, the age of patients varies from 18 years to 85 years. The maximum number of patients were from the age group of 31-40 years [28.57% (N=16)]. The 50% (N=28) of patients were diagnosed with Depressive mood disorder. A total of 169 drugs were prescribed out of which 52.07% (N=88) were Antidepressant drugs. Out of 88 Antidepressant drugs, 20% (N=18) patients received Venlafaxine, followed by 17% (N=15) Escitalopram. Out of 56, 26.78% (N=15) showed low adherence, 41.07% (N=23) showed medium adherence and 32.14% (N=18) showed High adherence.41.07% (N=23) patients were identified with drug use problems. Adverse drug reactions were suspected in 25% (N=14) patients. The most common type of Adverse reaction due to the drug was Weight gain (N=6 patients). Paroxetine drug was found with the highest number of ADRs 28.57% (N=4).
Conclusion: Most common antidepressant prescribed was Venlafaxine. Most Patients in the community included suffered from Depressive mood disorder with a maximum number of patients appeared from the age group of the thirties to forties. Patients due to their unstable mental status were adhering to therapy at medium levels. Drug use problem was identified commonly with patients on sedatives resulting them to either forget taking the pills or missing the dose. Patients generally had a common Adverse drug reaction of weight gain. Proper lifestyle modifications and patient counselling is required to benefit patient from treatment.
Keywords: Antidepressants, drug utilization, adverse drug reaction, medication adherence