A prospective observational study on psychotropic drug use in non psychiatric wards

Psychotropic medications are the first line for the management of psychiatric illnesses; in addition, they are also being used in an off-labeled manner. Inappropriate prescribing of psychotropic medications either can cause serious harm or may be of no benefit to the patients. However, there is a dearth of information on the pattern of psychotropic drug use in the nonpsychiatry wards.

The aim of this study is to assess the use of psychotropic drugs in general medicine and surgical wards of a teaching hospital.

An observational study was conducted in the general medicine and surgical wards of a university teaching hospital over 6 months. Patients admitted to the medicine and surgical ward were observed for a prescription of psychotropic medications. Once they were prescribed with a psychotropic medication, the patients were included in the study and were followed until discharge. All the necessary information such as dose, route, class of psychotropic and prescriber's status were documented and analyzed.

A total of 322 patients were prescribed with 452 psychotropic medications. The average number of psychotropic per patient was 1.40 ± 0.76 (range: 1-4). The rate of psychotropic medications prescription in the nonpsychiatric ward is 10.73%. Alcohol dependence syndrome (n = 90 [26.71%]) and pain (n = 43 [43.87%]) were the observed psychiatric and nonpsychiatric indications. The frequently prescribed psychotropic classes were benzodiazepines (n = 165 [36.50%]) and antidepressants (n = 144 [31.86%]). Nonpsychiatrists (n = 250 [55.3%]) were the common prescribers and benzodiazepines (n = 124 [27.43%]) were the preferred class for nonpsychiatrist, whereas psychiatrist prescribed different class of psychotropic drugs.

This study emphasizes that nonpsychiatrist irrespective of their specialty prescribed psychotropic medication for psychiatric and nonpsychiatric indications.