Evaluation of the interactions of psychotropic drugs in the prescriptions of doctors in Tabriz in 2022-2023

Abstract

Mental disorders (MDs) are distinguished by substantial impairments in cognition, affective regulation, or behavior. The global prevalence of MDs has increased from 12.9% in 1990 to 14.36% in 2021. Psychotropic medications are frequently employed to treat MD; however, they are associated with interactions and adverse effects. The rising prevalence of MDs correlates with a heightened risk of drug-drug interactions (DDIs) and adverse events. The objective of this investigation was to evaluate psychotropic DDIs in outpatient settings in Tabriz, Iran by examining prescriptions from the Iran Health Insurance Organization over a 12-month period. A topic that has not garnered significant focus within our county. Method: In this cross-sectional retrospective cohort study, health insurance data containing at least one item of psychotropic drug whose list was extracted from psychiatric references and compared with the Iranian pharmacopoeia and approved in a meeting with the presence of psychiatrists were obtained. Psychotropic DDI profiles were analyzed using Drugs.com. The database's comprehensiveness and the prevalence of psychotropic DDI were reported using descriptive statistics. Then, the prescriptions containing at least two psychotropic drugs were selected and statistically analyzed using Microsoft Excel, Python programming language and SPSS 27 software. Results: Our target population included 589,421 people, 20.4% of whom were prescribed psychotropic drugs. The average age of people who received psychotropic medication was 52.2 years. Gabapentin had the highest prescription rate with 54,729 cases (14.2% of all prescriptions). Sertraline was the second most prescribed drug with 29,268 prescriptions (7.6% of all prescriptions). Out of all the patients, 85,254 (37.5%) were men and 142,034 (62.5%) were women and had taken at least one psychotropic drug. 87709 prescriptions had at least two psychotropic drugs, 96% of the prescriptions had at least one drug interaction, and 4% of the prescriptions had no drug interaction. The highest percentage of interactions based on severity was related to the medium category with 83.2%. In the next category was the major category with 14.7%. Based on major, minor, and moderate interactions, psychiatrists and neurologists accounted for the majority of drug interactions and duplications. The most therapeutic duplications were related to antidepressants, with 62.7%. Antipsychotic duplications were also in the second place with about 30%. The most common major drug interaction in all prescriptions is related to sertraline-nortriptyline interaction, which constitutes 6.32% of major interactions. Clonazepam-elanzapine interaction is in the first place, with 3.74% in the prescriptions of psychiatrists. In the prescriptions of neurologists, sertraline-norepitheline interaction has the first rank with 13.41%.