France tackles psychotropic drug problem

BMJ 1996;312:997 (20 April)

News

France tackles psychotropic drug problem

French psychiatrist Professor Edouard Zarifian, who carriedout a year long study on the use of psychotropic drugs on behalfof the health ministry, has said that France now holds the worldrecord for the consumption of such drugs. He also claims thatovercon-sumption is "actively encouraged" by the pharmaceuticalindustry.

The per capita consumption in France of anxiolytic, hypnotic,antidepressant, and neuroleptic drugs is about three times greaterthan in Germany or Britain: 11% of adults in France take psychotropicdrugs at least once a week and for at least six months. A nationalsurvey has shown that one in seven prescriptions include atleast one psychotropic drug and that 83% of such prescriptionsare made out by general practitioners.

Professor Zarifian says that the pharmaceutical industry dominatescontinued medical education by sponsoring publications and meetingsand influencing the editorial content of medical publications."There is a clear intent to give doctors a monolithic representation[of mental health] reduced only to symptoms and accessible onlyto drugs," he says in his report. "The manner in which the linkbetween suicide and depression is presented is an example ofdisinformation with the final objective of having more antidepressantsprescribed."

Professor Zarifian said that sales of these drugs increasedby 7% from 1993 to 1994. He recognises that unemployment andincreasing social breakdown contribute to mental problems. Buthe fears that the boundary between normal and abnormal is becomingblurred, leading to a "pharmacological medicalisation of existence."

The report recommends a review of the packaging of psychotropicdrugs and continued education of doctors on the effects of psychotropicdrugs and the handling of mental problems. It also recommendsgiving as much independence as possible to the medical pressand establishing a surveillance network for the prescriptionand use of psychotropic drugs.

After receiving the report, Herve Gaymard, secretary of statefor health, acknowledged that excessive use of psychotropicdrugs in France was "a societal phenomenon that concerns allof us." Mr Gaymard announced plans for an evaluation and studyof medicinal prescriptions, notably of psychotropic drugs.--ALEXANDERDOROZYNSKI, medical journalist, Paris

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