Academic journal article Indian Journal of Psychiatry

IPS Multicentric Study: Antidepressant Prescription Patterns

Academic journal article Indian Journal of Psychiatry

IPS Multicentric Study: Antidepressant Prescription Patterns

Article excerpt

Byline: Sandeep. Grover, Ajit. Avasth, Kamal. Kalita, P. Dalal, G. Rao, R. Chadda, Bhavesh. Lakdawala, Govind. Bang, Kaustav. Chakraborty, Sudhir. Kumar, P. Singh, Puneet. Kathuria, M. Thirunavukarasu, P. S. V. N.. Sharma, T. Harish, Nilesh. Shah, Kamla. Deka

Background: There are very few studies from India which have evaluated the prescription pattern for antidepressants by psychiatrists for treatment of depression. Aim: To study the psychotropic prescription patterns of patients with first episode depression from diverse settings including teaching institutions in public and private sectors and even privately run psychiatric clinics. Materials and Methods: Prescription data of 706 patients with first episode depression, who participated in the IPS multicentric study, were evaluated. Results: Escitalopram was the most commonly prescribed antidepressant, comprising 40% of the total prescriptions. This was followed by sertraline (17.6%) and fluoxetine (16.3%). In total, selective serotonin reuptake inhibitors (SSRIs) formed 79.2% of all the prescriptions. Tricyclic antidepressants formed a small part (15.15%) of total prescriptions, with imipramine being the most commonly used tricyclic antidepressant. Serotonin-norepinephrine reuptake inhibitors (venlafaxine, desvenlafaxine and duloxetine) were prescribed to 11.3% of patients with equal share of venlafaxine and duloxetine. About one-sixth ( N=104; 14.7%) of the patients were prescribed more than one antidepressant. Nearly three-fourth of the patients ( N=523; 74.1%) were prescribed a benzodiazepine, with clonazepam being the most preferred agent, prescribed to nearly half of the participants (49%) and formed nearly two-third of the total benzodiazepine prescriptions (346 out of 523). Conclusion: Escitalopram is the most commonly prescribed antidepressant and SSRIs are the most commonly prescribed class of antidepressants. Poly pharmacy in the form of concomitant use of two antidepressants is practiced infrequently. However, benzodiazepines are used quite frequently as the co-prescription.

Introduction

Antidepressants form part and parcel of management of depression in majority of the cases. Over the years, the number of antidepressants available in India has increased and almost all the antidepressants available across the world are now available in India at an affordable price.

However, there is relative lack of data with respect to the prescription of antidepressants in India.

Very few studies have evaluated the prescription patterns of antidepressants from India. These studies have been invariably limited to only a particular center and there are no studies which have evaluated the prescription patterns across various treatment centers. A retrospective study from North India evaluated the antidepressants prescriptions of 108 patients of depression for the year 1996 and reported imipramine to be the most commonly prescribed antidepressant followed by fluoxetine. [sup][1] Another study evaluated the antidepressant prescription of 100 patients of depression and reported duloxetine to be the most commonly prescribed agent. About one sixth of the patients received more than one antidepressant and most of the patients were co-prescribed benzodiazepines, with clonazepam prescribed in 84% of cases, lorazepam in 73% of cases and nitrazepam in 46% of cases. [sup][2] In a recently published study, first prescriptions given to patients of depressive disorders attending the walk-in-clinic of a tertiary care center were evaluated. This study showed that escitalopram was the most commonly prescribed antidepressant; this was followed by sertraline, paroxetine, and venlafaxine. Among the benzodiazepines, clonazepam was the most commonly prescribed agent; this was followed by lorazepam. [sup][3]

Indian Psychiatric Society took an initiative to carry out a multicentric study which aimed to evaluate functional somatic complaints in patients of depression. …

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