Analysis of psychotropic medications prescriptions in Turkey

Year 2019, Volume: 3 Issue: 1, 1 - 15, 25.12.2019

Kezban Adam , Güvenç Koçkaya , Gulpembe Oguzhan

Abstract

In psychiatry, where definitive and clear diagnosis has been and still a major problem and where polypharmacy is common, off-label prescribing is particularly common. This study also informs the extent to which family physicians and non-psychiatrists are prescribing psychotropic medications. We used data from the 2014 IMS Health Turkey Medical Index (TMI). The survey in TMI data base is conducted each quarter in a sample of 705 medical doctors, which is projected to a universe of 62 562 physicians. The TMI is a nationally representative survey of an office-based panel of physicians to examine the diagnoses for which medications are being recommended. Descriptive analysis has been conducted with TMI data. Descriptive analysis has been conducted with TMI data about the consumption of psychotropic medications. Although there are limitations of the study, it is the first time an analysis conducted to understand the usage of psychotropic medications from a survey data in Turkey. Psychotropic medications are one of the most common and costly classes of prescription drugs in the substantial extent of prescription written by family physicians is of great concern, also. In order to improve quality and safety of health care services provided to patients and to ensure rational use of health care resources, it is essential to know the reasons why psychotropic medications are prescribed to patients.

Keywords

Psychotropic, prescriptions, turkey

References

• Azermai, M., Elseviers, M., Petrovic, M., Van Bortel, L., & Vander Stichele, R. (2011). Geriatric drug utilisation of psychotropics in Belgian nursing homes. Hum Psychopharmacol, 26(1), 12-20.
• Bhuvaneswar, C. G., Baldessarini, R. J., Harsh, V. L., & Alpert, J. E. (2009). Adverse endocrine and metabolic effects of psychotropic drugs: selective clinical review. CNS Drugs, 23(12), 1003-1021.
• Brijnath, B., Xia, T., Turner, L., & Mazza, D. (2017). Trends in GP prescribing of psychotropic medications among young patients aged 16–24 years: a case study analysis. BMC Psychiatry, 17, 214.
• Campayo, A., de Jonge, P., Roy, J. F., Saz, P., de la Camara, C., Quintanilla, M. A., ... Lobo, A. (2010). Depressive disorder and incident diabetes mellitus: the effect of characteristics of depression. Am J Psychiatry, 167(5), 580-588.
• Chang, K. J., Hong, C. H., Lee, Y., Lee, K. S., Roh, H. W., Back, J. H., ... Son, S. J. (2015). Effect of Psychotropic Drugs on Development of Diabetes Mellitus in Patients With Alzheimer's Disease. Medicine (Baltimore), 94(23), e919.
• Dworkin, R. H., O’Connor, A. B., Audette, J., Baron, R., Gourlayi G. K., Haanpaa, M. L., ... Wells, C. D. (2010). Recommendations for the pharmacological management of neuropathic pain: an overview and literature update. Mayo Clinic Proc, 85(3), S3-S14.
• FDA. Medication Guide Antidepressant Medicines, Depression and other Serious Mental Illnesses, and Suicidal Thoughts or Actions. https://www.fda.gov/media/72995/download
• Franzen, P. L., & Buysse, D. J. (2008). Sleep disturbances and depression: risk relationships for subsequent depression and therapeutic implications. Dialogues Clin Neurosci, 10(4), 473-481.
• Friedman, R. A. (2014). Antidepressants' Black-Box Warning - 10 Years Later. N Engl J Med, 371, 1666-1668.
• Gareri, P., Segura-Garcia, C., Manfredi, V. G. L., Bruni, A., Ciambrone, P., Cerminara, G., ... De Fazio, P. (2014). Use of atypical antipsychotics in the elderly: a clinical review. Clin Interv Aging, 9, 1363-1373.
• Gill, S. S., Bronskill, S. E., Normand, S. T., Anderson, G. M., Sykora, K., Lam, K., ... Rochon, P. A. (2007). Antipsychotic Drug Use and Mortality in Older Adults with Dementia. Ann Intern Med, 146, 775–786.
• Gulla, C., Selbaek, G., Flo, E., Kjome, R., Kirkevold, O., & Husebo, B. S. (2016). Multi-psychotropic drug prescription and the association to neuropsychiatric symptoms in three Norwegian nursing home cohorts between 2004 and 2011. BMC Geriatr, 16, 115.
• Guo, J. J., Keck, P. E., Corey-Lisle, P. K., Li, H., Jiang, D., Jang, R., & L’Italien, J. R. (2006). Risk of diabetes mellitus associated with atypical antipsychotic use among patients with bipolar disorder: A retrospective, population-based, case-control study. J Clin Psychiatry, 67(7), 1055-1061.
• Hamilton, M. (1989). Frequency of symptoms in melancholia (depressive illness). Br J Psychiatry, 154(2):201-206.
• Kharadi, D., Patel, K., Rana, D., & Patel, V. (2015). Off-label drug use in Psychiatry Outpatient Department: A prospective study at a Tertiary Care Teaching Hospital. Journal of Basic and Clinical Pharmacy, 6(2), 45-49.
• Larkin, I., Ang, D., Avorn, J., & Kesselheim, A. S. (2014). Restrictions on pharmaceutical detailing reduced off-label prescribing of antidepressants and antipsychotics in children. Health Aff (Millwood), 33(6),1014-1023.
• Mojtabai, R., & Olfson, M. J. (2008). National patterns in antidepressant treatment by psychiatrists and general medical providers: results from the national comorbidity survey replication. J Clin Psychiatry, 69(7), 1064-1074.
• Muneer, A. (2016). Pharmacotherapy of Acute Bipolar Depression in Adults: An Evidence Based Approach. Korean J Fam Med, 37(3), 137-148.
• Olie, J. P., Elomari, F., Spadone, C., & Lepine, J. P. (2002). Antidepressants consumption in the global population in France. Encephale, 28(5 Pt 1), 411-417.
• Patten, S. B., Esposito, E., & Carter, B. (2007). Reasons for antidepressant prescriptions in Canada. Pharmacoepidem. Drug Safe, 16, 746–752.
• Perlis, M. L., Giles, D. E., Buysse, D. J., Thase, M. E., Tu, X., & Kupfer, D. J. (1997). Which depressive symptoms are related to which sleep electroencephalographic variables? Biol Psychiatry, 42(10), 904-913.
• Pringsheim, T., & Gardner, D. M. (2014). Dispensed prescriptions for quetiapine and other second-generation antipsychotics in Canada from 2005 to 2012: a descriptive study. CMAJ Open, 2(4), E225–E232.
• Ranga, K., & Krishnan, R. (2005). Psychiatric and medical comorbidities of bipolar disorder. Psychosomatic Medicine, 67, 1-8.
• Steinberg, M., & Lyketsos, C. G. (2012). Atypical Antipsychotic use in patients with dementia: Managing safety. Am J Psychiatry, 169(9), 900-906.
• T.C. Sağlık Bakanlığı. Türkiye İlaç ve Tıbbi Cihaz Kurumu. Endikasyon Dışı İlaç Ek 4. https://www.titck.gov.tr/dinamikmodul/45.
• Tsuno, N., Besset, A., & Ritchie, K. (2005). Sleep and depression. J Clin Psychiatry, 66(10), 1254-1269.
• Vigen, C. L. P., Mack, W. J., Keefe, R. S. E., Sano, M., Sultzer, D. L., Stroup, T. S., ... Schneider, L. S. (2011). Cognitive effects of atypical antipsychotic medications in patients with Alzheimer’s