Expert opinion on psychopharmacological treatments for neuropsychiatric disorders in Indian settings

Objective: To gather clinicians’ perspectives on the use of psychopharmacological treatments for managing neuropsychiatric disorders, with a particular focus on medications such as citicoline, piracetam, selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, and divalproex sodium in Indian clinical settings. Methodology: This cross-sectional study was conducted among clinical experts across India and gathered feedback on clinical use, prescription practices, and experiences with psychopharmacological treatments for various neuropsychiatric disorders, emphasizing medications like citicoline, piracetam, SSRIs, benzodiazepines, and divalproex sodium. Participants independently completed a 23-item questionnaire after providing informed consent. Descriptive statistics were applied to analyze the data, with categorical variables expressed as percentages and visualized using pie and bar charts. Result: Of the 174 study participants, 71.84% preferred citicoline and piracetam for the treatment of post-stroke aphasia. Approximately 59% of clinicians identified cardiovascular disease and endocrine dysfunction as common comorbidities in patients with depression. Most respondents (75.86%) selected SSRIs as the first-line antidepressant, and around 65% recommended combining cognitive behavioral therapy (CBT) with medication for depression management. A significant majority (82%) of clinicians chose divalproex sodium for managing rapid cycling episodes of bipolar disorder (BD). For generalized anxiety disorder (GAD), 71% of participants favored a combination of SSRIs and benzodiazepines, with 67% recommending SSRIs for daytime anxiety relief. Additionally, nearly 82% of participants supported the use of both pharmacotherapy and psychotherapy for treating post-traumatic stress disorder (PTSD). Conclusion: This study provides insights into current pharmacological practices for various neuropsychiatric disorders, including post-stroke aphasia, depression, BD, GAD, and PTSD. Citicoline and piracetam are widely preferred for aphasia, SSRIs for depression, and divalproex sodium for BD. Combination therapies, including SSRIs, benzodiazepines, and psychotherapy, are emphasized for achieving optimal treatment outcomes.