Indian Essential Medicine List for mental disorders: Time to revisit

Abstract Background: Management of mental health issues remains far from satisfactory. The majority of these mental health disorders can be effectively managed by ensuring the availability of quality drugs in appropriate dosage forms. The essential drug list is the most effective instrument in ensuring the availability of these drugs to the majority of the population without financial burden. Aim and Objective: This study was performed to compare the drugs mentioned for mental disorders between the 21st World Health Organization (WHO) essential drug list, 5th Indian Essential Drug List, and 22nd WHO Essential Drug List to find out the need to update the Indian Essential Drug List. Materials and Methods: This descriptive study was carried out in the Department of Pharmacology at Dr. B. R. Ambedkar State Institute of Medical Sciences, Mohali, Punjab, India. The 5th National Essential Medicine List (NEML; latest edition) was compared with the 21st WHO Essential Drug List released in 2021 and the 22nd WHO Essential Drug List (latest edition) to find out the categories and subcategories of drugs, number of drugs mentioned in each category, drugs which are present in WHO Essential Medicine List (EML) but absent in Indian EML and vice versa. Results: A total of 17 drugs are mentioned in the 5th NEML for mental disorders compared with 25 in the 21st WHO Essential Drug List and 47 in the 22nd WHO Essential Drug List. Three subcategories: drugs for alcohol use disorders, drugs for nicotine use disorders, and drugs for opioid use disorders were mentioned in in 22nd WHO Essential Drug List but are absent in the 21st WHO Essential Drug List and 5th NEML. Important drugs, which are absent in Indian EML are risperidone therapeutic alternatives: aripiprazole, olanzapine, paliperidone, and quetiapine in psychotic disorders; fluoxetine therapeutic alternatives: citalopram, escitalopram, fluvoxamine, paroxetine, and sertraline in depressive disorders; and acamprosate calcium and naltrexone for alcohol use disorder. Conclusion: There is a need to update Indian EML for the effective management of mental disorders.