Drug Prescriptions in Psychiatry

One of the important tasks for psychiatrists is to provide treatment of psychiatric disorders mainly with the use of pharmaceutical agents besides other modalities of treatment. Drug prescription patterns in psychiatry practice often arouse interest in research circles. They have also attracted attention from ethical point of view. The important things in prescribing drugs to psychiatric patients involves a thorough diagnosis and adequate understanding of the patient's psychopathology and other psychosocial factors. Prescribing any inappropriate medication may prove to be very harmful and even criminal. Two important questions regarding drug prescription arise. Firstly, who should prescribe the drugs for psychiatric patients. Secondly, what should be the contents of the prescription. Regarding the first question there are no two opinions that it has to be a medically qualified person, it would be undersirable if non medical professionals are allowed to prescribe. Also, it would be preferable if the physician is trained in psychiatry either during housemanship or during postgraduation. Regarding contents of prescription it should be noted that only medications which are essentially beneficial for the patient should be prescribed. Many times practitioners have been noticed to prescribe number of drugs, as many as 10 to 12, to one patient. Many times practitioners prescribe more than one antip-sychotic, more than one antidepressant and more than one minor tranquillisers to the same patient besides prescribing tonics and hematenics. There is absolutely no rationale for such general prescription. Studies have shown that any one antipsychotic or antidepressant or minor tranquilisers may be better than a combination of these. The dosage of medications should be very carefully advised. Psychiatrists and other physicians should make it a point to educate and the patient and his family of both short term and long term side effects and complications. The patients can also be told about the possible methods to minimise these side effects. Some practitioners have the habit of advising very low doses. Others do not hesitate to prescribe massive doses in a short interval. We are aware that we do not have adequate facilities to monitor serum levels of the drugs in which case we can resort to the clinical parameters like clinical improvements and patients' side effects, complications, etc. to adjust the dosage. Multiple drugs or fixed drugs dosage combinations have not been very popular or effective. They increase the risk of drug interactions, drug side effects, cost factors for the patient, and many …