Analysis Of Prescribing Pattern And Adverse Drug Reactions of Selective Serotonin Reuptake Inhibitors (SSRIS) In A Psychiatry Out-Patient Department of A Tertiary Care Teaching Hospital

Abstract

Background: Selective Serotonin Reuptake Inhibitors (SSRIs) is a group of drugs which are widely used as antidepressants. Their use is not just limited as antidepressant but they are also useful in treatment of anxiety, bulimia nervosa (an eating disorder), obsessive-compulsive disorder, panic disorder, and premenstrual dysphoric disorder (PMDD). The drugs in this group are equally efficacious with minimum side effects, which are tolerable. Their safety profile is better as compared to tricyclic antidepressants. This study was designed with the aims to analyse the prescribing pattern and adverse drug reactions of SSRIs in psychiatry outpatient setup of tertiary care teaching hospital. Methodology: An observational cross sectional study conducted at psychiatric outpatient department of tertiary care teaching hospital over a period of three months. All the patients prescribed a selective serotonin re uptake inhibitor were enrolled in the study. Data regarding the demographic details, diagnosis, past and family history, presence of comorbid conditions, prescribed SSRI and other antipsychiatric drugs along with their dosage regimens and adverse drug reactions were entered in predesigned case record form analyzed in number and percentage.

Results: Majority of the patients (75 patients) were less than 50 years of age. Male to female ration was 1.17. Most common indication for prescribed SSRI is major depressive disorder (82 patients). 27 participants were having associated cormorbid conditions, Out of the six available SSRIs in hospital pharmacy, sertraline, escitalopram and fluoxetine were prescribed. Lorazepam, amitryptilin, clonazepam, diazepam and alprazolam were commonly co-prescribed antipsychiatric medications. Out of 35 patients developed adverse drug reactions, most common ADR was anxiety in 14% of patients followed by headache and alteration of appetite in 10% of patients each. Conclusion: Major depressive disorder was the most common indication for prescribing SSRI. Sertraline is the most commonly prescribed SSRI. The dosage range of prescribed  SSRIs were according to the standard therapeutic guidelines. Benzodiazepines were the most commonly co-prescribed antipsychiatric drugs. Percentage and type of occurrence of adverse drug reactions to SSRIs were similar to that found in literature. Future study of long duration is required to confirm these findings.. [Neelam S  Natl J Integr Res Med, 2019; 10(3):5-10]