[Symposium 95] Towards Better Patient Treatments in Asia: Based on the Research on Asian Psychotropic Prescription Patterns (REAP)

[SY-95-05] Prescription Pattern of Antidepressants in Thailand: A National Survey Result from the REAP-AD3 Study

*Pornjira Pariwatcharakul¹, Nopporn Tantirangsee², Chonnakarn Jatchavala³, Nitchawan Kerdcharoen⁴, Papan Thaipisuttikul⁹, Lampu Kosulwit⁵, Tiyarat Kayankit⁶, Pavarud Puangsri⁷, Poom Chompoosri⁸, Saratcha Tiensuntisook¹⁰, Sirina Satthapisit¹¹, Krittisak Anuroj¹², Amornrut Bangphichet¹³, Songpon Lodthanong¹⁴, Nuth Graipaspong¹⁵, Keerati Pattanaseri¹, Kantanut Yutrirak¹, Kritta Supanimitamorn¹, Woraphat Ratta-apha^1,16, Dutsadee Juengsiragulwit¹⁷ (1.Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok(Thailand), 2.Songkhla Rajanagarindra Psychiatric Hospital, Department of Mental Health, Ministry of Public Health(Thailand), 3.Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkla(Thailand), 4.Department of Psychiatry, Vajira Hospital, Navamindradhiraj University, Bangkok(Thailand), 5.Department of Psychiatry, Faculty of Medicine, Thammasat University, Pathumthani(Thailand), 6.Department of Psychiatry, Buddhachinaraj Hospital, Phitsanulok (Thailand), 7.School of Medicine Walailak University, Nakhon Si Thammarat (Thailand), 8.Department of Psychiatry, School of Medicine, Mae Fah Luang University, Chiang Rai(Thailand), 9.Department of Psychiatry, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok (Thailand), 10.Department of Psychiatry, Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan(Thailand), 11.Department of Psychiatry, Khon Kaen Hospital, Khon Kaen(Thailand), 12.Department of Psychiatry, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok(Thailand), 13.Department of Psychiatry, Takuapa Hospital, Phangnga(Thailand), 14.Trakanphuetphon Hospital, Ubon Ratchathani (Thailand), 15.Galya Rajanagarindra Institute, Bangkok(Thailand), 16.Siriraj Center of Research Excellence, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok (Thailand), 17.Department of Mental Health, Ministry of Public Health, Thailand(Thailand))

Keywords:

antidepressant,prescription pattern,psychiatric diagnoses,pharmacoepidemiology

Objectives: To explore the prescription pattern of antidepressants in Thailand and the diagnoses of the users.Methods: The Research on East Asia Psychotropic Prescription Patterns for Antidepressants, Phase 3 (REAP-AD3) project is a comprehensive, international, collaborative research consortium exploring the use of antidepressants in 11 Asian countries or regions. Data from Thailand were collected from 25 hospitals during December 2023 to March 2024. Participants were selected based on their use of antidepressant medication during the survey period. The inclusion criteria were: (i) age between 10 and 80 years, and (ii) taking at least one antidepressant. Clinical psychiatrists collected demographic, clinical, and prescription data at each survey center. Participants were asked to do self-report questionnaires, i.e., the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7), to measure their depressive and anxiety symptoms, respectively. All subjects granted informed consent. The study was approved by the Central Research Ethics Committee (study number: CREC071/66BR-SBR5).Results: The study included a total of 604 patients; 65.1% were female and 90.7% were outpatients. The most commonly prescribed antidepressants were selective serotonin reuptake inhibitors (SSRIs) (70.2%), followed by Tricyclic antidepressants (13.9%), serotonin antagonist and reuptake inhibitor (SARI) Trazodone (12.7%), SNRIs (7.9%), and Tetracyclic antidepressant, Mianserin (6.0%). The most common psychiatric disorders were depressive disorders (55%), including major depressive disorder (46.2%) and dysthymic (7.9%), anxiety disorders (26.2%), psychotic disorders (13.7%), substance use disorder (15.2%), bipolar disorder (4.8%), organic mental disorders (3.7%) and ADHD (1.8%).Conclusion: The study offers an extensive analysis of antidepressant prescription and diagnostic distribution in Thailand, highlighting the widespread usage of these medications and the considerable rate of off-label use. These findings highlight the necessity of customizing mental health care to specific contexts and pursuing additional research to assess the clinical implications for diverse prescribing strategies.