Pharmacotherapy of Bipolar Affective
Disorder: A Hospital based Study from Sub
Himalayan Valley of Nepal
Published: June 1, 2014 | DOI: https://doi.org/10.7860/JCDR/2014/.4524
Indrajit Banerjee, Brijesh Sathian, Prasanta Kumar Chakraborty, Indraneel Banerjee,
Bedanta Roy, Akhilesh Chandra Jauhari, Archana Saha
1. Lecturer, Department of Pharmacology, Manipal College of Medical Sciences, Pokhara, Nepal.
2. Assistant Professor, Department of Community Medicine, Manipal College of Medical Sciences, Pokhara, Nepal.
3. Professor, Department of Psychiatry, Manipal Teaching Hospital, Pokhara, Nepal.
4. Post Doctorate Trainee, Department of Urology, SMS Medical College Jaipur, Rajasthan, India.
5. Assistant Professor, Department of Physiology, Manipal College of Medical Sciences, Pokhara, Nepal.
6. Professor, Department of Pharmacology, Manipal College of Medical Sciences, Pokhara, Nepal.
7. Professor and Head of the Department of Pharmacology, Manipal College of Medical Sciences, Pokhara, Nepal.
Correspondence
Dr. Indrajit Banerjee,
Manipal College of Medical Sciences, Deep Heights-16. Pokhara-155, Kaski, Pin Code- 33700, Nepal.
Phone: 00977-9804100491, E-mail: indrajit18@gmail.com
Introduction: In Bipolar disorder the mood of the patients fluctuates between depression and mania. The main objective of the study was to find out the commonest mood stabilizers used for the treatment of Bipolar affective disorders in Western Nepal in hospitalized patients in an actual clinical set up.
Methods: This was a cross-sectional study which was conducted between October 2009 and September 2010 at Psychiatric ward at Manipal teaching hospital, Pokhara, Nepal, a tertiary care hospital situated in Western Nepal. The diagnosis of the disease was based on ICD-10 (Tenth revision) Classification of mental and Behavioural disorders, Diagnostic Criteria for Research. We calculated odds ratio and their 95% confidence intervals (95% CI). p<0.05 was considered as statistically significant.
Results: 62.1% of the patients were less than 40 yrs, 56.3% were male, 72.4% were unemployed and 75.9% of the patients were having monthly income <10,000/month. As far as ethnicity is concerned 37.9% of the cases were Brahmin and by occupation 29.9% of the patients were students followed by housewife 25.3%, labour 17.2%, retired 13.8% respectively. Drugs and Psychotherapy [OR 1.4, 95% (CI 0.575, 3.4017] was prescribed in age <40 years as compared to age>40 yrs. Male patients [OR 7.22, 95% (CI 0.862, 60.499)] and [OR 2.353, 95% (CI 0.857, 6.455)] received drugs by trade names and drugs not from the national drug list of Nepal as compared to females. Monthly income <10,000/month and [OR 2.8, 95% (CI 0.742, 10.56)] tendency of receiving drugs by trade names. Among the mood elevators Sodium valproate was the commonest drug to be prescribed in 51/87(58.6%) patients followed by Lithium in 30/87 (34.5%) cases and Carbamazepine in 6/87 (6.9%) cases. Sodium valproate was prescribed at 1,000 mg/day, Lithium was prescribed at 900 mg/day in and Carbamazepine was prescribed at 800 mg/day.
Conclusion: Among all the mood elevators Sodium valproate is the commonest drug prescribed for the treatment of bipolar affective disorder, recommended that there is a trend of using newer drugs like sodium valproate rather than the conventional mood stabilizers like Lithium for bipolar affective disorder in Western Development region of Nepal.
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