Assessment of drug utilization pattern and adverse drug monitoring among patients on antipsychotic drugs in a tertiary care hospital of Bihar: An observational and prospective study

Raushan Kumar Ranjan, Rajesh Kumar, Manish Kumar, Lalit Mohan, Saajid Hameed, Pankaj Kumar, Harihar Dikshit


Objective: There is increasing trend among psychiatrists to use newer psychotropic medications in their practice. Assessing the pattern of prescription and setting standards according to it should become part of clinical practice. Keeping this in mind, present study was planned to highlight the utilization pattern, comparing it with other studies and assess safety outcomes.
Materials and Methods: This was an observational and prospective study. One hundred forty-three (n=143) prescriptions were analysed and were followed up for 12 months. Patient on psychotropic drugswere screened for suspected Adverse Drug Reactions (ADRs) and were reported to AMC (Adverse Drug Reaction Monitoring Centre), Department of Pharmacology.
Result: Total 514 drugs were prescribed in 143 prescriptions. Total number of antipsychotic drugs prescribed was 375. The average number of antipsychotic drugs per prescription was 2.62. Among Antipsychotics atypical antipsychotics (64.52%) were prescribed more than typical antipsychotics (39.02%). Most commonly reported ADR was weight gain (28.38%) followed by sedation (14.19%), tremor (12.16%) and akathisia (10.81%). 6.08% of ADRs were Gastrointestinal side effects. Weight gain was found exclusively in atypical antipsychotics while tremor and akathisia were found mostly in typical ones.
Conclusion: Polypharmacy was avoided in prescriptions. Atypical antipsychotics were prescribed more than typical ones with olanzapine having highest percent drug utilisation. But this trend is increasing burden of obesity and metabolic syndrome in old age populations. The study results strongly suggest the need for healthcare team to focus on assessing and reporting suspected ADRs for enhancing the quality of monitoring and managing ADRs.

Full Text: