Prescribing pattern of antidepressants among patients with depression in a Mental Hospital of Nepal

Authors

  • Pragya Sharma MScPH, Kathmandu University School of Medical Sciences, Dhulikhel
  • Mr. Amrit lal Kathmandu University School of Science, Kathmandu University, Dhulikhel, Nepal
  • Puneet Shrestha Kathmandu University School of Science, Kathmandu University, Dhulikhel, Nepal
  • Bikram Gainju Kathmandu University School of Science, Kathmandu University, Dhulikhel, Nepal
  • Bhawani Tripathi Kathmandu University School of Science, Kathmandu University, Dhulikhel, Nepal
  • Nisha Bista Kathmandu University School of Science, Kathmandu University, Dhulikhel, Nepal

DOI:

https://doi.org/10.62992/ijphap.v2i3.39

Keywords:

Antidepressants, Depression, Escitalopram, Fluoxetine, Prescribing Pattern, SSRI

Abstract

Background: Depression is one of the major mental disorders and on the verge of emergence. Study on rational prescription of antidepressants is important since their inappropriate use may lead to precipitation of depressive symptoms.

Objective: To study prescribing pattern of antidepressants among patients diagnosed with depression and observe its concordance with recommended guidelines.

Methods: This retrospective study was conducted in Mental Hospital Patan, Nepal. All the patients (≥18 years) diagnosed with depression and prescribed at least one antidepressant were enrolled. Records of patients were selected on a daily registration basis from 2018/01/15 to 2018/05/14. Data collection form was designed to record details of eligible patients from the hospital. Statistical Package for the Social Sciences (SPSS) version 21 was used for data analysis.

Results: A total of 114 records were reviewed. More than half of patients (51.8%) were female. Patients in between age group of 18-27 years were maximum in number (25.4%). It was observed that Selective Serotonin Reuptake Inhibitors SSRIs (74%) were the most commonly prescribed antidepressant (escitalopram (33.33%) and fluoxetine (33.33%). The most frequently prescribed dosages for fluoxetine fell within American Psychiatry Association (APA) and Centers for Medicare & Medicaid Services (CMS) guidelines and specified in the Antidepressant Treatment History Form (ATHF); other antidepressants were found to be prescribed at lower than recommended doses.

Conclusion: Prescribed doses for antidepressants were found to be lower than that recommended by the available guidelines. More studies on understanding the prescribing pattern of antidepressants and literacy among the public on their rational use needs to be conducted in Nepal.

References

Risal A, Manandhar K, Linde M, Steiner TJ, Holen AJBp. Anxiety and depression in Nepal: prevalence, comorbidity and associations. 2016;16:1-9.

Lam MS, Fitzpatrick AL, Shrestha A, Karmacharya BM, Koju RP, Rao DJIjond. Determining the prevalence of and risk factors for depressive symptoms among adults in Nepal: findings from the Dhulikhel heart study. 2017;2(1):18-26.

Johnson CF, Williams B, MacGillivray SA, Dougall NJ, Maxwell MJBfp. ‘Doing the right thing’: factors influencing GP prescribing of antidepressants and prescribed doses. 2017;18:1-13.

Treviño LA, Ruble MW, Treviño K, Weinstein LM, Gresky DPJPS. Antidepressant medication prescribing practices for treatment of major depressive disorder. 2017;68(2):199-202.

Brijnath B, Xia T, Turner L, Mazza DJBp. Trends in GP prescribing of psychotropic medications among young patients aged 16–24 years: a case study analysis. 2017;17(1):1-8.

Avanthi E, Somashekar H, Kumar P, Sushma H, Sudarshan C, Raja BJIJBCP. Prescribing pattern of antidepressants in psychiatric unit of a tertiary care hospital. 2014;3(4):667-70.

Shrestha Manandhar J, Shrestha R, Basnet N, Silwal P, Shrestha H, Risal A, et al. Study of adherence pattern of antidepressants in patients with depression. 2017;57(1):3-9.

Gan Z, Li Y, Xie D, Shao C, Yang F, Shen Y, et al. The impact of educational status on the clinical features of major depressive disorder among Chinese women. 2012;136(3):988-92.

Cao B, Park C, Subramaniapillai M, Lee Y, Iacobucci M, Mansur RB, et al. The efficacy of vortioxetine on anhedonia in patients with major depressive disorder. 2019;10:17.

Tripathi A, Avasthi A, Desousa A, Bhagabati D, Shah N, Kallivayalil RA, et al. Prescription pattern of antidepressants in five tertiary care psychiatric centres of India. 2016;143(4):507.

Nahas ARF, Sulaiman SASJJoYP. Prescribing patterns of antidepressants among depressive men in Malaysia: a survey. 2018;10(1):98.

Downloads

Published

16-01-2024

Issue

Section

Original Article

Categories

How to Cite

1.
Prescribing pattern of antidepressants among patients with depression in a Mental Hospital of Nepal. IJPHAP [Internet]. 2024 Jan. 16 [cited 2024 Jul. 13];2(3):9-19. Available from: https://ijphap.com/index.php/home/article/view/39