Psychotropic drug prescriptions in primary care and general hospitals, in Saudi Arabia

Objective: Primary care and general hospital patients with diagnosed psychiatric disorders need appropriate psychotropic drugs and psychotherapeutic intervention in order to prevent chronic disabilities, so that they can have better quality of life. The present study compares psychotropic drug prescriptions by psychiatrists to primary care [n=402] and general hospital [n=138] patients referred to Buraidah Mental Health hospital. The collected data from these two sources were also compared with the previous published data on psychotropic drug prescribing for psychiatric outpatients [n=18265]. Method: Five hundred and forty psychiatric referrals together with outpatient files, retrieved randomly, were reviewed extensively for collecting relevant data on psychotropic drugs prescribing. Results: Several antipsychotics and anticholinergics were prescribed significantly to general hospital referred patients while antidepressants and anticonvulsants were prescribed significantly to primary care patients. However, the prescribed dosages of these psychotropics were not significantly varied between general hospital and primary care referred patients. Multiple psychotropic drugs were prescribed significantly to hospital patients as compared to primary care patients who received relatively less non-psychotropic intervention. On the other hand, antipsychotics, antidepressants and benzodiazepines were prescribed significantly to hospitals and primary care referred patients as compared to psychiatric hospital outpatients who filled significantly more prescriptions for anticonvulsants and anticholinergics. Conclusion: The pattern of prescription of psychotropics differs between primary health care and general hospital referred patients. The general practitioners and physicians need training in psychotropic drugs in order to prepare them competently to prescribe such drugs to patients presenting to them with a spectrum of psychological disorders. This will definitely reduce patient load on psychiatric hospitals.