Psychotropics

Physicians, however, are increasingly urged to exercise caution in prescribing such drugs.

Clinical studies have shown a higher risk of :

• withdrawal reaction upon discontinuation of benzodiazepines after long-term use;

• accidents, anterograde amnesia, and cognitive impairment particularly among elderly users.

To date, few epidemiological studies have provided the necessary information on psychotropic prescription and consumption habits in the general population to prevent the abuse and misuse of these drugs.

The present study investigated patterns of psychotropic medication consumption in the UK general population by assessing :

• psychotropic medication prevalence,

• type of medication prescribed,

• medical specialty of prescriber,

• indication of prescription,

• and use of over-the-counter products.

Psychiatric disorders and associated physical illnesses were also explored.
 

Research

The prevalence of psychotropic medication consumption was assessed in the UK by surveying a representative sample of 4972 non-institutionalized individuals 15 years of age or older (participation rate, 79.6%).

A questionnaire was administered over the telephone with the help of the Sleep-Eval Expert System. Topics covered included:

• type and name of medication,

• indication,

• dosage,

• duration of intake,

• medical specialty of prescriber.

• sociodemographics,

• physical illnesses,

• and DSM-IV mental disorders.

Results

Overall, 3.5% [95% CI: 3–4] of the sample reported current use of psychotropic medication.

Consumption was higher among women (4.6% [3.8–5.4]) than men (2.3% [1.7–2.9]), and among the elderly ($65 years of age).

The distribution of psychotropics was:

• hypnotics 1.5%,

• antidepressants 1.1%, and

• anxiolytics 0.8%.

The median duration of psychotropic intake was 52 weeks.

General practitioners were the most common prescribers of psychotropics (over 80% for each class of drug).

 Psychotropic users were:

• with a DSM-IV anxiety disorder for nearly half of the antidepressant users,

• with a DSM-IV depressive disorder for one-fifth of the anxiolytic users.

A marked improvement in sleep quality was reported by half the subjects using a psychotropic for sleep-enhancing purposes.

Psychotropic users were more likely than non-users to report episodes of memory loss, vertigo, or anomia.

Psychotropic medication consumption is lower and patterns of psychotropic prescription differ in the UK compared with other European and North American countries.

Results suggest that physicians may not be sufficiently trained to deal with the overlap between general practice and psychiatry.