Investigation of prescribed psychiatric medicines in Turkey

D. Bayram¹, I. Kirmizi¹, F. Isli², M. Aksoy², A. Akici¹. ¹Medical Pharmacology, Marmara University Medical Faculty, İstanbul, Turkey, ²Turkish Medicines and Medical Devices Agency, Ministry of Health, Ankara, Turkey.

Introduction: Along with differences among the countries, there are various concerns about the overuse of psychiatric medicines worldwide (1-3). In this study, we aimed to investigate utilization of the central nervous system drugs prescribed by adult psychiatrists (APs) and child psychiatrists (CPs) in Turkey.

Method: This retrospective study on prescription of psychiatric medicines with "N" group (nervous system drugs) at the level of anatomical therapeutic chemical-1 (ATC-1) basing on the national health data of APs and CPs obtained from Prescription Information System (PIS) of Turkish Medicines and Medical Devices Agency between January 1 and December 31, 2016. Distribution of medicines was analysed at the ATC-5 level in each group.

Results: The total number of items prescribed by both psychiatrist groups registered in the PIS was 2,034,912; and 95.5% of them were prescribed by APs. It was determined that 89.5% (n=1,739,619) and 97.8% (n=89,148) of total items prescribed by APs and CPs, respectively, were "N" group drugs. Ten most commonly prescribed medicines were escitalopram (10.2%), sertraline (9.0%), quetiapine (8.4%), duloxetine (7.0%), venlafaxine (6.3%), paroxetine (5.4%), fluoxetine (5.4%), olanzapine (5.0%), risperidone (4.7%), and mirtazapine (4.5%) among APs and methylphenidate (39.4%), risperidone (18.5%), fluoxetine (10.3%), sertraline (8.8%), atomoxetine (7.1%), aripiprazole (5.7%), quetiapine (1.4%), hydroxyzine (1.3%), imipramine (1.1%), and olanzapine (0.8%) among CPs. Based on this, it was determined that the first ten medicines, which were frequently preferred by APs and CPs, covered 65.9% and 94.4% of all items prescribed by these physicians, respectively.

Conclusions: It is understood that the drugs frequently prescribed by APs and CPs generally differ in both numeric and drug substance. Moreover, it is noteworthy that APs prescribe more antidepressants, most commonly escitalopram; and CPs prescribe methylphenidate more clearly. Compared with the literature, the obtained data exhibit partial similarities regarding prescribed medicines for children and adults (2,3).

References:

1. OECD (2015), Health At A Glance 2015: OECD Indicators, OECD Publishing, Paris:184-185.

2. Moore TJ and Mattison DR (2017). JAMA Intern Med 177:274-275.

3. Myong-Wuk Chon et al. (2017). J Korean Med Sci 32:1694-1701.