An audit of first prescription of new patients attending a psychiatry walk-in-clinic in north India

BACKGROUND: Although almost all psychotropic medications available worldwide are readily available in India, there is meager data in this country on the prescription patterns of psychiatrists. AIM: To study the first prescription handed over to patients attending the psychiatry outpatient clinic of a tertiary care hospital. MATERIALS AND METHODS: Data of all patients (for the period of January 1, 2009 to November 30, 2010; diagnosed with an ICD-10 diagnosis of F2-F4) were extracted from the computer-based registry and analyzed. RESULTS: Ten thousand two hundred and fourteen (10 214) patients were diagnosed to have a diagnosis of F2-F4 ICD-10 category. In all diagnostic groups, olanzapine was the most commonly prescribed antipsychotic followed by risperidone. Very few patients (8%) received typical antipsychotic medication. In all diagnostic groups, escitalopram was the most commonly prescribed antidepressant; other frequently prescribed antidepressants were sertraline, paroxetine, and venlafaxine. Among the mood stabilizers, valproate was preferred over lithium. In all the groups, more than half of the patients were prescribed benzodiazepines, clonazepam being the most commonly prescribed agent, followed by lorazepam. The mean number of psychotropic medications was highest in the bipolar disorder group. Very few patients received the combination of same group of drugs. CONCLUSIONS: Olanzapine, escitalopram, and clonazepam are the most commonly prescribed antipsychotic, antidepressants, and benzodiazepines, respectively. Valproate was preferred over lithium as a mood stabilizer. In general, the prescription trends were in accordance to the recommendations of various treatment guidelines, except for the use of benzodiazepines, which was higher.