Prescription of psychoactive drugs in patients attended by the SUS at Manhuaçu - MG (Brazil)
Objectives: In this study we present the development of a database of psychoactive drugs dispensed to patients attended by the Brazilian Public Health System (SUS) in the city of Manhuaçu, Minas Gerais and the pattern of drug prescription in this city.
Methods: 827 patients under psychoactive treatment and attended by SUS were surveyed and information such as gender, degree of education, age, marital status were collected. The collected data were analyzed in order to outline patients' profile and the dispensing and information was used to the access the pattern of psychoactive drug use in the city.
Results: Women accounted for 67.2% of the population and age seemed to influence positively the use of psychoactive drugs. Benzodiazepines and antidepressants were among the most prescribed drugs especially after 20 years of age, while in the younger population the antipsychotics and antiepileptics were the mainly prescribed drugs. Antiepileptics/mood stabilizers seemed to be prescribed mainly to single men and women.
Conclusion: Personal data concerning gender, age and marital status are related with psychoactive drug dispensing. The collected data will serve as a support for the performance of pharmacists responsible for dispensing psychoactive drugs in the municipality.
Keywords: Psychotropic Drugs. Drug Utilization. Age Factors. Brazil.
2. Pincus HA, Tanielian TL, Marcus SC, Olfson M, Zarin DA, Thompson J, Magno Zito J. Prescribing trends in psychotropic medications: primary care, psychiatry, and other medical specialties. JAMA. 1998;279(7):526-531.
3. Tajima O. Mental health care in Japan: recognition an treatment of depression and anxiety disorders. J Clin Psychiatry 2001;62 Suppl 13:39-44.
4. Ungvari GS, Chung YG, Chee YK, Fung-Shing N, Kwong TW, Chiu HF. The pharmacological treatment of schizophrenia in Chinese patients: a comparison of prescription patterns between 1996 and 1999. Br J Clin Pharmacol. 2002;54(4):437-444.
5. Sistema Nacional de Informações Tóxico Farmacológicas [Internet]. Evolução dos Casos Registrados de Intoxicação Humana por Agente Tóxico 2009. [cited 2010 Jul 14]. Available from: http://www.fiocruz.br/sinitox_novo/media/tab10_brasil_2007.pdf
6. Yusuff KB, Tayo F, Aina BA. Pharmacists’ participation in the documentation of medication history in a developing setting: An exploratory assessment with new criteria. Pharmacy Practice (Internet) 2010;8(2):139-145.
7. Tancredi FB. Aspectos Epidemiológicos do Consumo de Medicamentos Psicotrópicos pela População de Adultos do Distrito de São Paulo. Dissertação (Mestrado), Faculdade de Saúde Pública, Universidade de São Paulo, 1979.
8. Mari JJ, Almeida-Filho N, Coutinho E, Andreoli SB, Miranda CT, Streiner D. The epidemiology of psychotropic use in the city of São Paulo. Psychol Med. 1993;23(2):467-474.
9. Almeida LM, Coutinho ESF, Pepe VLE. Consumption of Psychotropic Drugs in an Administrative Region of the City of Rio de Janeiro: Ilha do Governador. Cad. Saúde Públ. 1994;10(1):5-16.
10. Noto AR, Carlini EA, Mastroianni PC, Alves VC, Galduróz JC, Kuroiwa W, Csizmar J, Costa A, Faria MA, Hidalgo SR, de Assis D, Nappo SA. Análise da prescrição e dispensação de medicamentos psicotrópicos em dois municípios do Estado de São Paulo. Rev Bras Psiquiatr. 2002;24(2):68-73.
11. Schappert SM, Rechtsteiner EA. Ambulatory medical care utilization estimates for 2006. Natl Health Stat Rep. 2008;6(8):1-29.
12. al-Ghamdy YS, Qureshi NA, Abdelghadir MH, al-Habeeb TA, Ahmad SA. Psychotropic drugs prescriptions in Al-Qassim region, Saudi Arabia. East Mediterr Health J. 1999;5(1):27-34.
13. Cafferata GL, Meyers SM. Pathways to psychotropic drugs: Understanding the basic of gender differences. Med Care. 1990;28:285-298.
14. Kroenke K, Spitzer RL. Gender differences in the reporting of physical and somatoform symptoms. Psychosom Med. 1998;60(2):150-155.
15. Gater R, Tansella M, Korten A, Tiemens BG, Mavreas VG, Olatawura MO. Sex differences in the prevalence and detection of depressive and anxiety disorders in general health care settings: report from the World Health Organization Collaborative Study on Psychological Problems in General Health Care. Arch Gen Psychiatry. 1998;55(5):405-413.
16. Bebbington P. The origins of sex differences in depressive disorder: Bridging the gap. Int Rev Psychiatry. 1996;8(4):295-332.
17. Murray JL, Lopez AD. The global burden of disease: A comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Boston: Harvard School of Public Health, World Health Organization; 1996.
18. Piccinelli M, Homen FG; Gender differences in the epidemiology of affective disorders and schizophrenia. Geneva: World Health Organization; 1997.
19. Haaxma CA, Bloem BR, Borm GF, Oyen WJ, Leenders KL, Eshuis S, Booij J, Dluzen DE, Horstink MW. Gender differences in Parkinson's disease. J Neurol Neurosurg Psychiatry. 2007;78(8):819-824.
20. Voyer P, Cohen D, Lauzon S, Collin J. Factors associated with psychotropic drug use among community-dwelling older persons: A review of empirical studies. BMC Nursing. 2004;3(1):3.
21. Cotten SR. Marital Status and Mental Health Revisited: Examining the Importance of Risk Factors and Resources. Fam Relat. 1999;48:225-233.
22. Stolker JJ, Heerdink ER, Leufkens HG, Clerkx MG, Nolen WA. Determinants of multiple psychotropic drug use in patients with mild intellectual disabilities or borderline intellectual functioning and psychiatric or behavioral disorders. Gen Hosp Psychiatry. 2001;23(6):345-349.
23. Blazer D, Hybels C, Simonsick E, Hanlon JT. Sedative, hypnotic, and antianxiety medication use in an aging cohort over ten years: a racial comparison. J Am Geriatr Soc. 2000;48:1073-1079.
24. Berg S, Dellasega C. The use of psychoactive medications and cognitive function in older adults. J Aging Health. 1996;8:136-149.
25. Beekman AT, Deeg DJ, van Tilburg T, Smit JH, Hooijer C, van Tilburg W. Major and minor depression in later life: a study of prevalence and risk factors. J Affect Disord. 1995;36:65-75.
26. Jorm AF. Does old age reduce the risk of anxiety and depression? A review of epidemiological studies across the adult life span. Psychol Med. 2000;30(1):11-22.
27. Munk-Jørgensen P. First-admission rates and marital status of schizophrenics. Acta Psychiatr Scand. 1987;76(2):210-216.
28. Sridharan R. Epidemiology of epilepsy. Curr Sci India. 2002;82(6):664-670.
29. Sovner R. A clinically significant interaction between carbamazepine and valproic acid. J Clin Psychopharmacol. 1998;8:448-449.
30. Dunlop BW, Davis PG. Combination Treatment With Benzodiazepines and SSRIs for Comorbid Anxiety and Depression: A Review. Prim Care Companion J Clin Psychiatry. 2008:10(3):222-228.
31. Smith WT, Londborg PD, Glaudin V, Painter JR. Short-term augmentation of fluoxetine with clonazepam in the treatment of depression: a double-blind study. Am J Psychiatry. 1998;155:1339–1345.
32. Patel IH, Levy RH, Cutler RE. Phenobarbital--valporic acid interaction. Clin Pharmacol Ther. 1980;27:515–521.
33. Keitner GI, Rahman S. Reversible neurotoxicity with combined lithium-haloperidol administration. J Clin Psychopharmacol. 1984;4(2):104-105.
34. Pearson HJ. Interaction of fluoxetine with carbamazepine. J Clin Psychiatry. 1990;51:126.
35. Brœsen K. Kragh-Sœrensen P. Concomitant intake of nortriptyline and carbamazepine.Ther Drug Monit. 1993;15:258-260.
36. Spina E, Pisani F, Perucca E. Clinically significant pharmacokinetic drug interactions with carbamazepine. An update. Clin Pharmacokinet. 1996;31(3):198-214.
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