Department of Psychiatry, PGIMER, Chandigarh, India.
Department of Psychiatry, S N Medical College, Agra, Uttar Pradesh, India.
Indian J Psychiatry. 2014 Jul;56(3):253-64. doi: 10.4103/0019-5545.140632.
There is a lack of national level data from India on prescription of psychotropics by psychiatrists.
This study aimed to assess the first prescription handed over to the psychiatrically ill patients whenever they contact a psychiatrist.
Data were collected across 11 centers. Psychiatric diagnosis was made as per the International Classification of Diseases Classification of Mental and Behavioural Disorders 10(th) edition criteria based on Mini International Neuropsychiatric Interview, and the data of psychotropic prescriptions was collected.
Study included 4480 patients, slightly more than half of the subjects were of male (54.8%) and most of the participants were married (71.8%). Half of the participants were from the urban background, and about half (46.9%) were educated up to or beyond high school. The most common diagnostic category was that of affective disorders (54.3%), followed by Neurotic, stress-related and somatoform disorders (22.2%) and psychotic disorders (19.1%). Other diagnostic categories formed a very small proportion of the study participants. Among the antidepressants, most commonly prescribed antidepressant included escitalopram followed by sertraline. Escitalopram was the most common antidepressant across 7 out of 11 centers and second most common in three centers. Among the antipsychotics, the most commonly prescribed antipsychotic was olanzapine followed by risperidone. Olanzapine was the most commonly prescribed antipsychotic across 6 out of 11 centers and second most common antipsychotic across rest of the centers. Among the mood stabilizers valproate was prescribed more often, and it was the most commonly prescribed mood stabilizer in 8 out of 11 centers. Clonazepam was prescribed as anxiolytic about 5 times more commonly than lorazepam. Clonazepam was the most common benzodiazepine prescribed in 6 out of the 11 centers. Rate of polypharmacy was low.
Escitalopram is the most commonly prescribed antidepressant, olanzapine is the most commonly prescribed antipsychotic and clonazepam is most commonly prescribed benzodiazepine. There are very few variations in prescription patterns across various centers.
印度缺乏关于精神科医生开具精神药物的国家级数据。
本研究旨在评估精神科医生每次接触精神病患者时开出的第一张处方。
数据在 11 个中心收集。精神科诊断是根据国际疾病分类第十版精神和行为障碍分类标准,使用迷你国际神经精神访谈进行的,同时收集了精神药物处方的数据。
研究纳入了 4480 名患者,略多于一半的受试者为男性(54.8%),大多数为已婚(71.8%)。一半的参与者来自城市背景,约一半(46.9%)受过高中或以上教育。最常见的诊断类别是情感障碍(54.3%),其次是神经症、应激相关和躯体形式障碍(22.2%)和精神病性障碍(19.1%)。其他诊断类别在研究参与者中所占比例很小。在抗抑郁药中,最常开的抗抑郁药是依他普仑,其次是舍曲林。依他普仑是 11 个中心中的 7 个中心最常开的抗抑郁药,也是另外 3 个中心中第二常开的抗抑郁药。在抗精神病药中,最常开的抗精神病药是奥氮平,其次是利培酮。奥氮平是 11 个中心中的 6 个中心最常开的抗精神病药,也是其余中心中第二常开的抗精神病药。在心境稳定剂中,丙戊酸盐的使用频率更高,它是 11 个中心中的 8 个中心最常开的心境稳定剂。氯硝西泮作为抗焦虑药的使用频率比劳拉西泮高约 5 倍。氯硝西泮是 11 个中心中的 6 个中心最常开的苯二氮䓬类药物。联合用药的比例较低。
依他普仑是最常开的抗抑郁药,奥氮平是最常开的抗精神病药,氯硝西泮是最常开的苯二氮䓬类药物。各中心的处方模式差异很小。