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Doctors warn against overuse of tranquillisers

The Times of India News Service,
April 11, 2001
by Lalit Kumar

NOIDA: General physicians and other non-psychiatrist doctors in Noida routinely prescribe tranquillisers and anti-depressants, which may contribute to various forms of drug addiction and other mental problems.

A cross-section of doctors here told The Times of India News Service, that psychiatric drugs, beside being habit forming could also mask some psychological problems, making the ailment more difficult to diagnose.

Managing director of Noida Medicare Centre Navin Chowdhary agrees. "There is an obvious and unhappy trend among many GPs and registered medical practitioners to over-prescribe sedatives and other drugs affecting the central nervous system. This trend should strictly be discouraged," he says.

Kailash hospital chairman Mahesh Sharma echoed the view. "Many RMPs are adding anti-anxiety medicines to prescriptions for common colds, just to make the patient feel good," he added.

"Also, cardiologists, gastro-enterologists and even gynaecologists often prescribe anti-depressants indiscriminately. Sleeping pills like nitrazepam are heavily over-prescribed. Often patients continue to take these drugs on their own, without knowing the ill effects," says Pradeep Agarwal, a Lady Hardinge Medical College professor of psychiatry. When stopped suddenly, the drugs could cause withdrawal symptoms.

Agarwal said alprazolam, a commonly prescribed anxiolytic drug, is "possibly the country's most over-prescribed and mis-prescribed drug." It can cause dependence in about a month, he said.

Santosh Medical College senior lecturer in psychiatry T Jagawat says there is enough evidence to suggest such misuse. "Over 80 per cent of the patients we see have already been prescribed anxiolytic, anti-depressant or anti-psychotic drugs - usually in incorrect dosages or for inappropriate durations," he says.

Jagawat says when psychiatrists don't prescribe drugs for fevers or coughs, why should general physicians prescribe them for depressions or neuroses?

But NMC psychiatry consultant P K Das points out that the family doctor often has a genuine problem. "If a patient is referred to a psychiatrist, he may not return. He might feel insulted that he is being diagnosed as crazy," he added.

So what does the family doctor do when faced with psychosomatic problems or hysteria? Das believes the doctor's duty is to explain the situation to the patient and describe psychiatric intervention as just another kind of medical treatment.

"The physician can also call the psychiatrist to his clinic, where the patient may feel more comfortable. The psychiatrist can usually follow-up from there," he added.

Noida Indian Medical Association chief Alka Ray agrees. "All qualified doctors sometimes need to use tranquillisers. But the treatment of mental ailments is the psychiatrist's domain," she said.

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