A report by Turkish association for psychopharmacology on the psychotropic drug usage in turkey and medical, ethical and economical consequences of current applications | [Psikofarmakoloji Derne?i Türkiye'de psikotrop ilaç tüketimi ve mevcut uygulamalaridotlessn tidotlessbbi, etik ve ekonomik sonuçlaridotless raporu]

Abstract

This report evaluation of the psychotropic drug usage in Turkey based on the data provided by Intercontinental Marketing Service (IMSHealth), Ministry of Health, Turkish Statistical Institute, Turkish Mental Health Profile. A total of 14.24 millions units of antidepressants were used in 2003. By increasing 162%, annual antidepressant usage reached 37.35 millions units by the end of 2012. Antipsychotic drug usage increased by 71% during the last 5 years, from 7.20 millions units in 2005 to 12.32 millions as of the end of 2012. The total number of prescriptions including an antidepressant was 18.14 millions in 2007, by increasing 50% in the last 5 years, it reached 26.60 millions in 2012. The total number of prescriptions including any antipsychotic drug increased from 3.92 millions in 2007 to 5.76 millions in 2012, increasing by 46.7%. In the worst case scenario considering concurrent psychiatric disorders, prevalence of disorders requiring antidepressants and antipsychotic drugs could be as high as 20% and 5%, respectively. The calculated frequency (prescription/population) was much higher than the worst case scenario estimates. In 2007, family physicans and practitioners, psychiatrists, neurologists, and specialists of other disciplines prescribed 33, 37, 20, and 11% of all antidepressants, respectively. In 2012, they prescribed 48, 31, 14, and 7% of all antidepressants, respectively. The first time antidepressant prescriptions in 2012 were done at the rate of 37, 34, 19, and 11% by above mentioned specialists, respectively. In 2007, family physicans and practitioners, psychiatrists, neurologists, and specialists of other disciplines prescribed 18, 67, 13, and 3% of all antipsychotics, respectively. In 2012, the same set of specialisations prescribed 21, 63, 14, and 2% of antipsychotics, respectively. The "first time" antipsychotics were prescribed at the rate of 6, 73, 19, and 3% by above mentioned order of specialists, respectively. In conclusion, the data suggest that there was an unnecessary and/or excessive prescribing of psychotropic agents. The increase is not related to increased population and/or prevalance of psychiatric disorders. The numbers of first time prescriptions suggest that non-psychiatrists diagnose and initiate treatment for psychiatric disorders. This requires re-evaluation of authorization to presribe psychotropic agents.