ANTIDEPRESSANT UTILIZATION TRENDS AND RATIONALITY A DRUG USE EVALUATION APPROACH IN TERTIARY CARE PSYCHIATRY

Abstract

Depression and other psychiatric disorders represent a significant public health burden worldwide, with antidepressants being the cornerstone of pharmacological management. However, inappropriate prescribing, irrational drug use, and polypharmacy remain major concerns in clinical practice. This study aimed to evaluate the prescribing trends and rationality of antidepressant utilization in psychiatric patients at a tertiary care hospital. A prospective, observational drug use evaluation (DUE) study was conducted over a defined period, including patients diagnosed with depressive disorders and prescribed antidepressant therapy. Data on demographic profile, clinical diagnosis, type and class of antidepressants, concomitant medications, dosage, duration, and adherence to standard treatment guidelines were collected and analyzed. The study findings revealed selective serotonin reuptake inhibitors (SSRIs) as the most commonly prescribed class, followed by serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants (TCAs). Rationality was assessed based on WHO prescribing indicators, drug–drug interactions, and alignment with clinical guidelines. The evaluation highlighted the rational use of antidepressants in the majority of cases, though certain issues such as polypharmacy, prolonged duration of therapy, and occasional nonadherence to guidelines were observed. The study underscores the need for continuous prescription audits, physician education, and the implementation of evidence-based guidelines to optimize antidepressant therapy and improve patient outcomes in psychiatric care.