title: Pattern of psychotropic prescription in a tertiary care center: a critical analysis.
abstract: OBJECTIVE
  To study the prescription pattern of psychotropic drugs in a Tertiary Care Hospital in Eastern India with special reference to polypharmacy.
  
  
  METHODS
  A total of 411 patients were included in the study through systematic sampling. Patients were diagnosed by a Consultant Psychiatrist before inclusion in the study using a semi-structured interview schedule based on the International Classification of Disease (ICD), classification of mental and behavioral disorders, 10th version). The most recently prescribed psychopharmacological medication of those patients was studied. A checklist to assess the pattern of prescription and evaluate reasons of polypharmacy was filled up by the prescribing consultant.
  
  
  RESULTS
  About 76.6% of the patients received polypharmacy in the index study. Males were more exposed to polypharmacy compared to women (80.93% vs. 70.85%). Gender and diagnosis had a predictive value with regard to the polypharmacy. Polypharmacy was more common in organic mental disorders (F0), psychoactive substance abuse disorders (F1), psychotic disorders (F2), mood disorders (F3) and in childhood, and adolescent mental disorders (F9). Most frequently, antipsychotic drugs were prescribed followed by tranquilizers/hypnotics and anticholinergics. Antidepressants (35.13%) were more commonly prescribed as monotherapy. Anticholinergics (100%) and tranquilizers/hypnotics (96.7%) were the drugs more commonly used in combination with other psychotropics. The three most common reasons for prescribing polypharmacy were augmentation (43.8%) of primary drug followed by its use to prevent adverse effects of primary drug (39.6%) and to treat comorbidity (34.9%).
  
  
  CONCLUSIONS
  Polypharmacy is a common practice despite the research based guidelines suggest otherwise. More vigorous research is needed to address this sensitive issue.
authors.affiliation: Department of Psychiatry, College of Medicine and J.N.M. Hospital, West Bengal University of Health Sciences, Kalyani, West Bengal, India.
authors.forename: Pinaki
authors.initials: P
authors.lastname: Sarkar
authors.forename: Kaustav
authors.initials: K
authors.lastname: Chakraborty
authors.forename: Ajaya
authors.initials: A
authors.lastname: Misra
authors.forename: Rajnikant
authors.initials: R
authors.lastname: Shukla
authors.forename: Sarada Prasanna
authors.initials: SP
authors.lastname: Swain
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D008875:Middle Aged; D019338:Polypharmacy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs
keywords: Polypharmacy; prescription patterns; psychotropics