Mood disorders and their management in a Nigerian Tertiary Health Institution.
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Date
2010
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Department of Pharmacology and Therapeutics, Ahmadu Bello University, Zaria, Nigeria.
Abstract
ABSTRACT
The objective of this study was to evaluate the management of mood disorders at Ahmadu Bello University Teaching Hospital (ABUTH) with a view to suggesting improvements. The method employed was retrospective and utilized patients hospital records for a period of one year, using structured data forms. All patients diagnosed of mood disorders (n- 145) were included in study. Data were analyzed using SPSS version 11. The results showed that patients were managed with pharmacotherapy alone in 35.2% of cases, or with a combination of psychotherapy and pharmacotherapy. Drugs employed mainly were antipsychotics such as chlorpromazine (73.8%%) and trifluoperazine (52.4%); antidepressants like tricyclics- amitripty line (63.4%); sedative-hypnoties which were mainly diazepam (49.7%) and nitrazepam (45.5%). Other drugs included anticonvulsants as mood stabilizers e.g. carbamazepine (35.2%); and benzhexol (83.4%). Most patients (74.5%) experienced side effects to the drugs, such as weakness, headaches and excessive sleep which were managed by reduction in dosage /frequency of administration, discontinuation of the implicated drugs and use of adjunct to treat side effects.
Electroconvulsive therapy was the principal form of non-pharmacological management employed, others being counseling, psychotherapy, traditional medicine and religion. Pharmacoeconomic analysis showed the average cost of drugs per patient per annum to be NI5,772.27 and NI8,136.04 for psychiatry and total drugs (i.e. both psychiatry and non-psychiatry drugs) respectively; which was considered high given the unemployment status of most patients (60.7%). Mood disorders at ABUTH were still being managed by the traditional drugs, mainly typical antipsychotics and tricyclic antidepressants rather than the newer more effective, but expensive drugs like lamotrigine and venlafaxine. It is suggested that concerted efforts to subsidize treatment (including use of newer drugs), be made e.g. via increased enrolment into the National Health Insurance Scheme.
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Keywords
Mood disorders, Management, Nigeria, Health institution, Psychotherapy