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

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.