Prescribing Pattern and Adverse Drug Reaction Profiles in Patients with Bipolar Mood Disorder at A Tertiary Care Teaching Hospital

Background: A combination of manic (bipolar mania), hypomanic (bipolar depression), and depressed (bipolar mania) episodes, together with notable subsyndromal symptoms that often manifest in between major mood episodes, describe bipolar mood disorder

Aim: To study the prescribing pattern and adverse drug reaction profiles in patients with bipolar mood disorder at a tertiary care teaching hospital.

Methods: This study was an observational, prospective and hospital -based cross sectional study conducted at Psychiatry department (both OPD & IPD) of Silchar Medical College and Hospital from March,2023-February,2024. 70 patients suffering from bipolar mood disorder were included.

Results: 46 patients (27.06%) were prescribed sodium valproate and 1 patient (0.58%) were prescribed carbamazepine. Among antidepressants, 6 patients (3.53%) were prescribed Fluoxetine and 7 patients (4.12%) were prescribed Sertraline. Most common combination drug sodium valproate + olanzapine was prescribed in 40% of the patients. Dry mouth occurred in 2 patients (3.92%), drowsiness occurred in drowsiness (13.73%), weight gain in 24 patients (47.06%) 3 patients (5.88%) had tremors, 12 patients (23.53%) had G.I upset and 3 patients (5.88%) had alopecia. Based on causality terms, 9 (17.65%) were classified as probable and 42 patients (82.35%) as possible. Based on severity of ADR, 42 patients (82.35%) were classified as mild and 9 patients (17.65%) as moderate.

Conclusion: Most commonly prescribed medication in patient with bipolar mood disorder in the Department of Psychiatry is the combination of Sodium Valproate & Olanzapine followed by the combination of Lithium, Olanzapine & Quetiapine. Existing data suggested that continuous administration of lithium, anticonvulsants & antipsychotics provides symptomatic relief in mood disorder & simultaneously causes various adverse drug reactions.