Utilisation of psychotropic medications
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چکیده
The timely article by Verdoux & Begaud ́ hopefully begins to redress the imbalance between randomised controlled trials and other ways of evaluating drug treatments. I would like to present further evidence for the ‘gap between guidelines and utilisation . . . for psychotropic medications’ (Verdoux & Begaud, 2004). ́ Using the Drug Report of the German Public Health Insurance (Schwabe & Pfaffrath, 1996), which is a database of all prescriptions reimbursed by the general health insurance system (which accounts for more than 80% of all prescriptions), and a database from the Institute for Medical Statistics, Frankfurt/Main, which refers to a representative sample of 2806 physicians in private practice who report four times a year all prescriptions during 1 week, we found that only 14% of prescriptions for neuroleptic drugs were for schizophrenic psychoses, 18% for other paranoid psychoses and 5% for affective disorders (Linden & Thiels, 2001). Almost half of the neuroleptic prescriptions were written for patients aged 65 years or older. Over the period 1986 to 1995 the prescribing of neuroleptics increased steadily in parallel with a decrease in prescriptions for benzodiazepines. Also I would like to contradict the assumption that antipsychotics are ‘mainly prescribed by specialists’ (Verdoux & Begaud, 2004). Using the pharmacó epidemiological data described above, we found that only 40% of neuroleptic drugs were prescribed by psychiatrists/neurologists (i.e. by Nervenarzten ̈ who trained in both specialties, as most German psychiatrists and neurologists do). Data from a 6-month prospective drug utilisation observation study on 3858 women and 1594 men prescribed the selective serotonin reuptake inhibitor sertraline shows that it is not only the type of psychotropic drug that determines whether it is ‘commonly prescribed by primary care practitioners’ (Verdoux & Begaud, 2004) ́ but also the gender of the patient. A higher percentage of women with depression were treated by general practitioners, compared with men with depression who were more likely to be seen by psychiatrists, although women were more likely to present with recurrent rather than first-episode depression and to have been previously treated for depression.
منابع مشابه
A rapid appraisal of access to and utilisation of psychotropic medicines in Bihar, India
BACKGROUND A major aspect of providing mental healthcare is access to and use of psychotropic medications. Bihar is a state in northeast India with limited mental healthcare provision; consequently access to and utilisation of psychotropic medications are likely to be limited. However, to date there has been no research assessing the situation. This study therefore aims to analyse the psychotro...
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Prescribing Pattern of Psychotropic Medications in Psychiatry Outpatients at a Tertiary Care Teaching Hospital in India: A Prospective Cross-sectional Study
Background and Objectives: The expanding field of psychopharmacology is constantly seeking new and improved drugs to treat psychiatric disorders. Although psychotropic drugs have had a remarkable impact in psychiatry, their utilization, effectiveness, and side effects in the in clinical practice need continuous study. The present study was thus designed to analyze the pattern of psychotropic dr...
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Pharmacoepidemiological studies exploring utilisation of psychotropic medications in real-life conditions are required to identify extension of indications, since the risk of gap between the theoretical target population and the population actually treated is especially marked for this class of drugs. A large proportion of subjects from the general population are exposed to psychotropic medicat...
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OBJECTIVES The aim of this study was to assess the pattern and utilisation of psychotropic drug prescriptions by psychiatrists in Kerman Province, Iran. METHODS The prescriptions of 27 psychiatrists were randomly selected from two Iranian public insurance organisations and were analysed for the mean number of drugs/prescriptions, drug category and the most frequently prescribed drug in each c...
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To date, antipsychotics remain the mainstay of treatment for schizophrenia and related disorders although other psychotropic medications and non-pharmaceutical interventions have been used adjunctively in some patients and settings. Regular surveys on access to and prescription patterns of psychotropic medications in clinical practice are an important and efficient way of examining the use and ...
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