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Psychotropic medications are widely prescribed, but how new classes of psychotropic medications have affected prescribing patterns has not been well documented.
To examine changes between 1985 and 1994 (data from 1993 and 1994 were combined) in the prescribing patterns of psychotropic medications by office-based primary care physicians, psychiatris...
Context in source publication
Context 1
... drugs were classified ac- cording to the 1994 Physicians' Desk Ref- erence 14 and the Drug Evaluations An- nual 1994. 15 Antidepressants, antianxi- ety drugs and hypnotics, antipsychotics, psychostimulants, and lithium are consid- ered in Table 1. A psychotropic drug visit is defined as a visit in which at least 1 psychotropic drug was prescribed, or- dered, supplied, administered, or contin- ued; an antidepressant visit is defined as a visit in which at least 1 antidepressant was prescribed and so forth. ...
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Citations
... Recent studies have shown that the prescription of psychotropic drugs to adults, adolescents and young children has dramatically increased over the past several decades [1][2][3][4][5][6]. Glasser reported that as of 1994, psychotropic medications represented nearly 9% of all prescriptions on the drug market [5]. ...
There is substantial evidence linking the consumption of psychotropic medications with leading to mania, hostility, violence, and even homicidal ideation yet little is still known regarding the link between psychiatric drugs and acts of senseless violence. These drugs, whether administered to treat depression, mania, or anxiety, have neurological side effects that frequently enhance the probability of additional comorbid mental health outcomes. A special class of psychotropic medications, called selective serotonin reuptake inhibitors (SSRIs) are consistently involved in producing a varied range of maladaptive mental and behavioral conditions. The purpose of this paper is to examine in detail the neurological processes that may be involved in these negative outcomes and present a prospective for future research in neurosciences to develop a 'risk-benefit' profile for treating children and adolescents.
... They frequently don't follow the recommendations for evidence-based practice very closely (Calfee, 2002).{12} When doctors are aware of a medication that works, they also focus more on diagnosing illnesses (Pincus et al., 1998;Elliott, 2002). [13-14} According to this group of research, health can be enhanced by more quickly disseminating knowledge about novel medications or novel uses. ...
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brands, including generic drugs, biologics, vaccines, formula drugs, and investments in corporate cures. This is due to the ongoing advancements in science and biological research, as well as the growing demand for realistic scenarios in a range of medical contexts One of the trademarks of pharmaceutical presentations
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... 1,2 Psychotropic medications, consisting of psycho stimulants, antidepressants, mood stabilizers, antipsychotics, and anxiolytics, are the pillars in the management of these SMIs. 3,4 The effective management of people with SMIs requires a complete approach that helps to control their symptoms. 5 According to the World Health Organization medication adherence is the degree to which a person follows the generally recognized recommendations of a healthcare professional by following a diet, taking prescription medication, and/or making lifestyle modifications. ...
... Psychotropic medication: is defined as medication consisting of antidepressants, anxiolytics, antipsychotics, psycho stimulants, and/or mood stabilizers. 3 ...
... To further identify and prevent redundant factors that could have an impact on our estimate, the variance inflation factor (VIF) was used to analyze the multicollinearity of the explanatory variables. The VIF fell within a reasonable range (1)(2)(3)(4)(5). 32 The study's findings were then presented utilizing texts, tables, and figures depending on the findings. ...
Background
Psychotropic medications, consisting of antidepressants, mood stabilizers, antipsychotics, and anxiolytics, are the pillars of managing mental illnesses. Since there is impairment in judgment, attitude, and stability in patients with severe mental conditions, they are vulnerable to non-adherence, which compromises treatment outcome. Nevertheless, a lack of studies investigating medication non-adherence and its predictors in severe mental illnesses patients in Ethiopia has been noticed. The purpose of this study was to evaluate the extent of non-adherence to psychotropic medication and its predictors in patients with severe mental illnesses in Ethiopia.
Patients and Methods
A cross-sectional study was carried out among severely ill mental patients attending outpatient psychiatry department at Debre Markos Comprehensive Specialized Hospital. Stratified sampling strategy was used to enroll patients with a variety of mental diseases. The determinants of non-adherence were identified using logistic regression analysis. Statistical significance was determined by a p-value of <0.05 and a 95% confidence range.
Results
The prevalence of non-adherence to psychotropic medication was 50.9%. Missing regular follow-up [AOR (95% CI): 2.36 (1.24–4.47)], current substance use [AOR (95% CI): 2.48 (1.44–4.27)], negative attitude towards treatment [AOR (95% CI); 3.87 (2.26–6.62)], experience of side effects [AOR (95% CI); 4.84 (2.74–8.54)], medication use for more than 3 years [AOR (95% CI); 7.16 (3.93–13.06)], and no family support [AOR (95% CI); 2.07 (1.19–3.58)] were predictors of psychotropic medication non-adherence.
Conclusion
This study generalized that most of the patients were non-adherent to their medications. Missing regular follow-up, current substance use, negative attitude towards treatment, experience of side effects, Medication use for more than 3 years and absence of family support were found to influence medication adherence of the patients. In order to correct patients’, caregivers’, and societal misconceptions regarding the significance of treatment adherence, we recommend the need to implement psycho-educational programs.
... A lot of factors affect the presentation of patients to OPDlike geographical factor, cultural factors, and environmental factors and prescribing pattern of practitioners. 3 Recently, a number of newer therapeutic modalities have evolved. It is necessary to evaluate the prescribing pattern in psychiatric OPDs to reduce overuse, misuse and to improve rationality and cost effectiveness of prescriptions. ...
Background: Psychiatric morbidity is on the rise in the developing economy India. Little data is available forpolicy makers to develop guidelines for rational and cost effective prescription of psychotropic drugs.Aims and Objectives: The present study aims to analyze the prescription pattern of psychotropic drugs in apsychiatric Out Patient Department.Materials and Methods: This was a Hospital based prospective analysis of 100 Psychiatric OPD prescriptions.Consent was obtained prior enrollment. Pharmacological data along with clinical and demographical profile wascollected and analyzed. Data was collected in MS Excel and presented as numbers and percentages in the form oftables and figures.Results: There was an equal gender distribution. Most of the patients belonged to the age group of 20-40 years(55%).Depression(38%) was the most common diagnosis among all the prescriptions evaluated. The most commonlyprescribed drugs were antidepressants(38%) followed by anxiolytics, antipsychotics and mood stabilizers.Conclusion: Prescribing pattern was in accordance with standard guidelines. This data gives a brief overview ofthe psychotropics prescription pattern in our demographic region.
... Pharmacological therapy, psychotherapy, and psychosocial rehabilitation are the main components of treating mental illness (4). The prescription pattern of psychotropic medication use in psychiatric practice has changed dramatically (5). ...
Mental and behavioral disorders are common around the world. Pharmacotherapy, psychotherapy, and psychosocial rehabilitation are three treatment components for these disorders. Drug therapy is an essential part of the comprehensive treatment of these diseases. Their use pattern in psychiatric practice has changed dramatically in recent years. Mental disorders require long-term treatment. Therefore, it is crucial to study the prescribing practices of these groups of drugs. This study aims to assess drug use patterns using the WHO/INRUD Core Prescribing Indicators. Patients of both genders and ages with mental illness and prescription psychiatric drugs were evaluated from the outpatient department of the Psychiatry Unit (OPD). The prescription data were collected and analyzed using the indicators recommended by the WHO/INRUD. The data were analyzed using Microsoft Excel-2007. The percentage and average values of the variables were compared. A total of 655 prescriptions were analyzed. Male patients (54.96%) were more than women (45.04%). The morbidity profile included schizophrenia (37.86%), alcohol use disorder (18.78%), major depressive disorder (11.30%), anxiety disorder (10.23%), bipolar disorder (4.88%), and others (16.95%). The newer antipsychotic were the most commonly prescribed drugs (particularly olanzapine), along with a central anticholinergic (trihexyphenidyl) and a benzodiazepine (lorazepam). The percentage of drugs prescribed with generic names was 39.80%, and that of drugs prescribed by NLEM was 48.49%. The average number of drugs prescribed per prescription was 2.58. This study's Index of Rational Prescribing (IRDP) was 3.87, whereas the optimal score was 5. Prescriptions were complete, and principles of rational prescribing were followed, except for a low generic prescribing rate.
... However, presence of suicidal behavior does not necessarily predict overall poor clinical outcome. [34,27] In terms of sleep architecture, depressed individuals generally have lesser total sleep time, longer sleep latency, frequent awakenings, greater wake-after-sleep onset and offset times, lesser sleep efficiency, and a tendency to wake up earlier than controls. [21,23,45] Severity of depression has also been found to be associated with differences in sleep architecture. ...
All age groups, including children and adolescents, are susceptible to depression, a common mental illness. Depression is commonly connected with substantial impairment in children and adolescents. The leading global contributor to disease and incapacity is depression. Research documenting the incidence of depression among children and adolescents indicate large percentages of youngsters in both groups with depressed symptoms. This review aims to analyze Indian research on depression is among adolescent and younger adults. This article also have major goal is to examine the scientific data on adolescent depression screening, diagnosis, and treatment, with a focus on primary care settings, history of depression, pathology and treatment of depression. The risk factors for moderate to severe depressive disorders in adolescents and young adults were discovered in the current investigation. At the end in this review we will offer some recommendations for treating depression and enhancing general mental health.
... Selective serotonin reuptake inhibitors (37.5%) were the most frequently prescribed antidepressants in this study and this is in consonance with other studies 5,42 . In a study in Canada50 SSRIs (17.5%) were the most frequently prescribed antidepressants followed by venlafaxine (7.4%). ...
Psychiatry disorders are creating its own place in morbidity these days. Various factors like cost of drugs, local paradigms, etc, plays a critical role for selecting the appropriate therapy for a particular patient because usually they are chronic therapy. Keeping this in mind, we conducted a study to delineate the various drugs used in psychiatric disorders, to find discrepancies. Drug utilization studies are essential for correct use of drug. Our study identifies the problems that arise from drug usage in health care delivery system and highlights the current approaches to the rational use of drugs. A total of 518 patients’ data were collected during the period and analyzed for WHO recommended prescribing and complementary indicators. Study shows low incidence of poly pharmacy which is good as poly pharmacy is common in psychiatry and also use of injections was very low. Study shows that prescribing from WHO List of Essential Medicine was not as good as it accounted for only 21.3%. There is scope for improvement in case of medicines prescribed by generic name as none were prescribed by generic name. The average cost per prescription in our study was only 9.41 Indian rupees per day which is affordable by the majority of the patients.
... The rate at which psychotropic drugs such as stimulants, antidepressants, and antipsychotic medications get prescribed to children and adolescents in the USA has increased dramatically during the 1990s (Mojtabai & Olfson, 2020;Moreno et al., 2007;Olfson et al., 2002Olfson et al., , 2006Olfson et al., , 2012Pincus et al., 1998), and the increase has continued and, for certain drugs, accelerated after 1999 (Comer et al., 2010;Thomas et al., 2006). These trends clearly coincide with the declines in juvenile violence over the recent decades (Baumer et al., 2021), especially the continuing throughout the 2010s declines in homicide perpetrated by youth (Tcherni-Buzzeo, 2019), echoed by the continuing homicide declines in many European countries (Suonpää et al., 2022). ...
The increasing rates at which psychotropic drugs have been prescribed to children and adolescents in the USA in the last three decades (since the early 1990s) have prompted questions about whether this trend is associated with the “great American crime decline.” Medicalization can be considered one of the strategies to remedy children’s neuropsychological deficits and improve their self-control. Another possible remedy is school-based services for children with learning disabilities, mandated by the Individuals with Disabilities Education Improvement Act (IDEA) of 2004. Using state-level panel data analyses for years 1990–2014 (with the main focus on 2000–2014 outcomes), the current study estimates associations between these two developmental self-control remedies—medicalization and school-based services—and minor, moderate, and severe types of juvenile violence, while controlling for relevant covariates (both time-varying and time-invariant). The results of mixed-effects linear regression analyses accounting for powerful time trends show a strong association between increases in school-based services for children with learning disabilities and declines in all types of juvenile violence. Another strong and consistent finding that emerges in the analyses is the link between reductions in child poverty at the state level and decreases in juvenile violence, both contemporaneously and over time. Psychotropic drug prescribing to children (measured using Supplemental Security Income rolls of children with mental health conditions) exhibits inconsistent or insignificant effects. The findings of this study have substantial theoretical and policy implications and indicate the importance of strengthening school-based services for children with disabilities and reducing child poverty as essential violence prevention tools.
... Depression is a severely debilitating mental health condition that affects~300 million individuals worldwide and is now a leading global disability burden [1,2]. Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (FT) are routinely prescribed for depression, as well as for a range of co-morbid conditions such as anxiety and bipolar disorder [3,4]. Approximately 81% of patients diagnosed as depressed receive at least one prescription for antidepressants (ADs), with SSRIs constituting 60% of such prescriptions (~250 million people worldwide) [5,6]. ...
Depression and anxiety are major global health burdens. Although SSRIs targeting the serotonergic system are prescribed over 200 million times annually, they have variable therapeutic efficacy and side effects, and mechanisms of action remain incompletely understood. Here, we comprehensively characterise the molecular landscape of gene regulatory changes associated with fluoxetine, a widely-used SSRI. We performed multimodal analysis of SSRI response in 27 mammalian brain regions using 310 bulk RNA-seq and H3K27ac ChIP-seq datasets, followed by in-depth characterisation of two hippocampal regions using single-cell RNA-seq (20 datasets). Remarkably, fluoxetine induced profound region-specific shifts in gene expression and chromatin state, including in the nucleus accumbens shell, locus coeruleus and septal areas, as well as in more well-studied regions such as the raphe and hippocampal dentate gyrus. Expression changes were strongly enriched at GWAS loci for depression and antidepressant drug response, stressing the relevance to human phenotypes. We observed differential expression at dozens of signalling receptors and pathways, many of which are previously unknown. Single-cell analysis revealed stark differences in fluoxetine response between the dorsal and ventral hippocampal dentate gyri, particularly in oligodendrocytes, mossy cells and inhibitory neurons. Across diverse brain regions, integrative omics analysis consistently suggested increased energy metabolism via oxidative phosphorylation and mitochondrial changes, which we corroborated in vitro; this may thus constitute a shared mechanism of action of fluoxetine. Similarly, we observed pervasive chromatin remodelling signatures across the brain. Our study reveals unexpected regional and cell type-specific heterogeneity in SSRI action, highlights under-studied brain regions that may play a major role in antidepressant response, and provides a rich resource of candidate cell types, genes, gene regulatory elements and pathways for mechanistic analysis and identifying new therapeutic targets for depression and anxiety.
... However, MDD has been assumed to occupy the place of the second cause of disability by 2020, and MDD, therefore, demands attention and alerts physicians of clinical psychiatry. 2,3 According to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-4), five symptoms need to be present among nine for 2 weeks to diagnose a person suffering from MDD. One such symptom is either depressed mood or loss of interest or pleasure. ...
Background: Major Depressive Disorder (MDD) is a major health problem. In Bangladesh, the prevalence of depressive disorder is 4.1%. MDD is the second cause of disability and therefore, alerts physicians of clinical psychiatry. Antidepressants are the treatment of depression. Administration of zinc indicates an important role in mood and depression. Objective: To investigate the role of zinc in MDD. Materials and Methods: A randomized controlled trial; done in the Department of Pharmacology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from March 2019 to August 2020. Placebo group with SSRI was group ‘A’ (n =35) and zinc supplementation with Selective serotonin reuptake inhibitors (SSRIs) was group ‘B’ (n=38) for 8 weeks. A baseline visit and a follow-up visit were given after 8 weeks. Then; the severity of depression and serum zinc level was assessed. Results: After 8 weeks, the Depression, Anxiety and Stress Scale (DASS-21) score was found 11.77 ± 4.08 SD and 8.53 ± 4.38 SD in placebo and intervention group respectively. Percentage of decreased DASS-21 score was found 37.68 ± 21.47 SD and 54.48 ± 21.94 SD in placebo and intervention groups respectively. The DASS-21 score was statistically significant. The more significant reduction of DASS-21 score after zinc administration. After 8 weeks, serum zinc levels were found 0.69 ± 0.10 SD in the placebo group and 0.78 ± 0.12 SD in the intervention group. The percentage of changes in the serum zinc level in the placebo group was 0.19 ± 16.17 and in the intervention group 5.88 ± 18.39. The serum zinc levels were significant within the intervention groups. The significant elevation of serum zinc levels after 8 weeks of zinc administration in the intervention group. Conclusion: Zinc supplementation along with SSRI in MDD patients significantly ameliorated the severity of depression. KYAMC Journal Vol. 13, No. 01, April 2022: 18-23
