Assessing drug utilization and drug–drug interactions in the management of epilepsy, Alzheimer’s, Parkinson’s disease and migraine

Abstract

Neurological disorders (ND) affect the structure and function of the central nervous system, including Alzheimer’s and Parkinson’s diseases, epilepsy, migraine and stroke. ND has major symptoms ranging from mild to severe memory problems and physical disabilities. The present study investigated central nervous system (CNS) drug utilization trends, drug–drug interaction and morbidity patterns in ND. A prospective study was carried out at a multi-specialty hospital, including neurology outpatient cases, in 2016. A study was ethically approved by the institutional ethics committee (IEC) for human research, and data were collected from patients’ case records. The prescribing trend was assessed by World Health Organization (WHO) core prescribing indicators. The International Classification of Diseases (ICD) 10 was used to assess the morbidity pattern. Drug–drug interactions were analysed by a multidrug interaction checker. We discovered that 53.57% and 46.42% of the 280 neurology cases were female and male, respectively. Here, we showed that epilepsy was the most commonly diagnosed (31.07%) condition, followed by migraine (30.35%), Parkinsonism (Pn) (13.21%), Alzheimer’s and dementia (AD) (10.71%) and myasthenia gravis (7.14%). The most commonly used CNS drugs were sodium valproates. Donepezil, fluoxatin and levodopa–carbidopa. In this study, 80% of drugs were prescribed with the most common category being antiepileptics; 16.77% and 23.21% of prescriptions observed potential drug–drug interactions. The treatment priority for epilepsy was sodium valproate, which had a high prescription rate. For AD, donepezil was given priority, while in PN, levodopa–carbidopa was prescribed most often. In significant drug–drug interactions (DDI), pharmacodynamic mechanisms were very common, while in minor DDI, pharmacokinetic mechanisms were observed.