Safety and use of medicines in mental health at the psychiatric hospital of the Republic of Tatarstan (Russia)

Article type: Research Article

Authors: Ziganshina, Lilia E.^; | Kuchaeva, Alexandra V. | Vedernikova, Olga O. | Gatin, Foat F. | Ziganshin, Airat U.

Affiliations: Department of Clinical Pharmacology and Pharmacotherapy, Kazan State Medical Academy, Kazan, Russian Federation | Republican Clinical Psychiatric Hospital, Kazan, Russian Federation | Department of Pharmacology for Pharmaceutical Faculty, Kazan State Medical University, Kazan, Russian Federation

Note: [] Corresponding author: Professor Lilia E. Ziganshina, 11 Mushtary Street, Kazan 420012, Russia. Tel.: +7 843 273 08 02; E-mail: [email protected].

Abstract: Neuroleptics' safety and use survey was conducted with the aim to develop a drug use monitoring system at a regional psychiatric hospital as an efficient tool of improving use of anti-psychotics. 7080 Side-effects report slips included into the regular medical charts for the period of 4 years (2000–2003) and 385 medical charts for the twelve months of the year 1960 were studied. The total daily neuroleptic load was calculated with the help of Chlorpromazine equivalents and ATC/DDD methodology. It was confirmed that clinical form of paranoid schizophrenia, age and gender contribute to the increased susceptibility of patients to development of movement disorders: women, patients over 60 years of age and youngsters, and patients with cerebral-organic deficiency being the most vulnerable. The most common patterns of inadequate prescribing practice included needless overuse of neuroleptics; combination treatment of highly dosed neuroleptics; simultaneous prescribing of anticholinergics (trihexyphenidyl) with neuroleptics; clozapine use only as a sedative component. Pharmacovigilance system proved to be an effective instrument in monitoring but not necessarily improving prescribing practices.

Journal: International Journal of Risk and Safety in Medicine, vol. 18, no. 2, pp. 83-90, 2006