First prescription of new elderly patients attending the psychiatry outpatient of a tertiary care institute in North India.

AIM: There is lack of data on prescription patterns in elderly patients from developing countries. The aim of this study is to examine the first prescription given to elderly patients (age >60 years) attending the psychiatry outpatient clinic of a tertiary care hospital.

METHODS

In this retrospective study, data on patients older than 60 years attending the psychiatric outpatient clinic of a tertiary care hospital between 1 January 2009 and 30 November 2010 were extracted from the computer-based registry and analyzed.

RESULTS

During the study period, 1192 new patients older than and equal to 60 years registered with the psychiatric outpatient clinic. Exact prescription data was available for 975 patients. The most common major diagnostic group was mood disorders (33.9%), followed by neurotic, stress-related and somatoform disorders (23.1%). Across all diagnostic groups, olanzapine was the most commonly prescribed antipsychotic medication (20.7% of patients with an organic mental disorder, 40.8% with psychotic disorder, 30.2% with bipolar disorder); quetiapine and risperidone were the other commonly prescribed antipsychotics. Across all diagnostic groups, escitalopram was the most commonly prescribed antidepressant, and sertraline was the second most frequently prescribed SSRI. Among mood stabilizers, valproate was preferred over lithium (25.4% vs.12.7%). Sedative-hypnotic medications were frequently prescribed across all diagnostic groups. Clonazepam and lorazepam were the most often prescribed benzodiazepines. The mean number of psychotropic medications was highest among bipolar disorder patients (1.84) and least among the patients with an organic mental disorder (1.25).

CONCLUSIONS

Olanzapine, SSRI and clonazepam were the most commonly prescribed antipsychotic, antidepressant, and benzodiazepine, respectively, and valproate was preferred over lithium among elderly patients with bipolar disorder.