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OFF-LABEL USE OF ANTIPSYCHOTICS AND ANTIDEPRESSANTS- A DOUBLE EDGED SWORD -- OBLIGES A CLOSE MONITORING
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  • Pankaj Pant,
  • Puneet Dhamija,
  • Yusra Ahmad,
  • Pallavi Srivastava
Pankaj Pant
DIT University
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Puneet Dhamija
AIIMS Rishikesh
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Yusra Ahmad
Uttarakhand Technical University
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Pallavi Srivastava
AIIMS Rishikesh
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Abstract

Nowadays the prescription of off-label in psychiatric practice is very common, exclusively in the pregnant women, pediatric and geriatric groups due to the lack of available standards and alternatives, that elevate the safety issue in the vulnerable groups. This observational study performed in a Tertiary Care Teaching Hospital for six months prospectively and retrospectively. It involved 549 patients with a mean age of 37.13 ± 12.62 years (range 9–81 years) and male: female ratio was 1:1.3, showing a higher incidence of the female population as compared to previous Indian studies which reported a higher population of males. We found approximately 1550 drugs prescriptions in which the 44% were antipsychotic and antidepressants. The indication of drugs was found to be 560 in numbers, in which 31.5% of drugs prescription not found any distinguish indication. Amitriptyline 19.51% was the most commonly prescribed drug followed by the Escitalopram 17.0%, Clonazepam 12.1%, Fluoxetine 11.2%, Sertraline 6.5%, etc. Also the various adverse effect association recorded with this prescribing pattern. The off-label prescription was ascertaining with the application of drug package insert (US-FDA) and National formulary of India 2011 and 2016 was used as a reference basis to ascertain the off-label prescribing. Wide variability was noticed in prescribing practices among clinicians, however it is not limited to psychiatric only. The conclusion of the study underlined a prerequisite accountability of healthcare professional on the way to safe medication practices through a lot of scientific evidence for the risks and benefits profiling of off-label medication