Deprescribing of benzodiazepines and Z-drugs amongst the psychiatric patients of a tertiary care Hospital

2019 ◽  
Vol 44 ◽  
pp. 189-194 ◽  
Author(s):  
Halumatha Surendra Shree Shilpa ◽  
N. Naveen Kumar ◽  
Eswaran Maheswari ◽  
Harave Shanmugam Virupaksha ◽  
Viswam Subeesh ◽  
...  
Author(s):  
Vasundhara Yerkade ◽  
Riyaz Ahmed Siddiqui

Background: In psychiatric practice, antidepressant drugs are widely used group of drugs. Number of drugs are available in this group with diverse type of mechanisms and efficacy/safety profile. The objective for the study was to identify the prescribing pattern of antidepressant drugs in psychiatric patients at a tertiary care hospital and to see the distribution of antidepressant drugs in the sociodemographic group.Methods: It was a record based descriptive study which was carried out at NKP Salve Institute of Medical Sciences and Research Centre, Nagpur. Case record files of all the patients suffering from depression and other psychiatric disorders and treated with antidepressant drugs during the period of from 1st January 2015 to 31st December 2015 by institutional psychiatrists were analyzed for prescription pattern of antidepressant drugs and their age and sex wise distribution.Results: A total no. of 300 patients received antidepressant drugs. The most commonly prescribed drug was escitalopram in 121 (40.3%) patients followed by fluoxetine in 61 (20.3%) and clomipramine in 30 (10%) patients. Other drugs that were prescribed were mirtazapine in 24 (8%), nortryptiline in 21 (7%), venlafaxine in 13 (4.3%), fluvoxamine in 12 (4%), amitryptiline in 9 (3%), dothiepin in 5 (1.6%) and duloxetine in 4 (1.3%) patients. Also patients in the age group of 31-40 yrs and 21-30 yrs received most number of antidepressants i.e. 129 (40.3%) and 83 (27.6%) patients respectively. Females have received more antidepressant drugs as compared to males.Conclusions: Selective Serotonin Reuptake Inhibitors (SSRIs) are the most commonly prescribed group of antidepressant drugs. Escitalopram followed by Fluoxetine were the most commonly prescribed drugs for the management of depression and other psychiatric disorders because of their better efficacy, safety, tolerability and less side effects as compared to TCAs. Females suffer more from depression and other psychiatric disorders as compared to males and the most vulnerable is 21 to 40 yrs of age.


2018 ◽  
Vol 7 (2) ◽  
pp. 31-35 ◽  
Author(s):  
N. Rai ◽  
P. Pokhrel ◽  
P.P. Sharma ◽  
M. Basnet ◽  
B. Dahal ◽  
...  

Introduction: Mental illness accounts for 14% of all disability adjusted life years (DALYs) lost worldwide and is one of the major contributors to the global burden of disease. In spite of this much of burden and disability there is a huge gap between the treatment and help seeking behavior. Though, the mental illness is a common problem, due to stigma and lack of knowledge they prefer to visit alternative sources like faith healers, traditional practitioners and quacks. Very few of them seek psychiatrists help. So, this pathway to care study aims to provide some descriptive insight into the pathways to care among the psychiatric patients attending the tertiary care hospital in Kathmandu valley. Material and Method: A cross-sectional study among 66 patients seeking psychiatric outpatient services in Kist medical College, Imadole, Lalitpur, Nepal which is a Teriatry hospital from the period of 1st August – 31st October, 2018. Semi structured proforma developed by department of Psychiatry which covered the socio-demographic profile and WHO (1987) collaborative “pathway study” encounter form as a guiding tool was used to collect the data. Results: Out of 66 enrolled patients, 60.6% were in the age group of 21-40. Almost equal proportion of male (51.5%) and female (48.5%) visited psychiatric services. Majority of the patients were married (81.8%), Chhetri (25.8%) by caste and Hindu (81.8%) by religion. Majority of the patients were from outside valley (51.5), educated upto primary level (31.8%) and housewife by occupation (28.8%). The most common diagnosis was Depression (16.7%) and Alcohol Dependence syndrome (16.7%). Majority (45.5 %) of the patients had visited faith healer before visiting to Psychiatrists. 57.6 % patient visited psychiatrists within 2.5 months duration and majority of them were initiated to visit psychiatrists by family members/ relatives. Conclusion: Faith healers were the most common first contact for psychiatric patients. Despite of that majority of the patients had visited psychiatrists within 2.5 months duration. In most of the cases family members/ relatives were the one to initiate for psychiatric consultation.


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