english.prescrire.org > Positions > Overmedication > Mental health: putting patients first

Theme: Overmedication

We’ve got a pill for just about everything these days. Healthcare professionals are under pressure to prescribe medications which may do no good, and might even do much harm. How can we resist the urge to overmedicate existence?

Mental health: putting patients first

The current emphasis on mental health should not be seen as an opportunity to medicalise everything or to propose insufficiently evaluated drugs. While mental suffering is very real, the solutions do not always involve the prescription of medicine or drugs. This suffering cannot justify the sale of inadequately evaluated drugs.

In September 2006, the European Parliament adopted a report indicating that “one in four people in Europe experience at least one significant episode of mental ill health during their lives”. This debatable estimate is among the worrying figures that are increasingly quoted, and which often come from sources with links to pharmaceutical companies.

The European Parliament’s interest in issues such as mental health is welcome, but the authorities must act in the best interests of patients rather than in the interests of the pharmaceutical industry. And in the field of psychotropic drugs, the new drugs offer patients precious few benefits. For example pregabalin, an antiepileptic drug, and escitalopram, an antidepressant, now approved for the treatment of “general anxiety”, offer no advantage. General anxiety requires psychological treatment first of all and sometimes calls for the use of tranquilisers (benzodiazepines).

Worse still, sertindole, a neuroleptic withdrawn from the market two years after its commercialisation in 1996 because of its cardiac toxicity, now has a marketing authorisation for schizophrenic disorders, despite the absence of improved efficacy.

While mental suffering is very real, the solutions do not always involve the prescription of medicine or drugs. This suffering cannot justify the sale of inadequately evaluated drugs.

©Prescrire 2007

Source: “Santé mentale (suite)” Rev Prescrire 2007 ; 27 (279) : 4.