FACTORS INFLUENCING THE PRESCRIBING OF ]] NOOTROPIC[[ MEDICATIONS - RESULTS OF A REPRESENTATIVE INQUIRY IN LOWER SAXONY

Aim of investigation: To discover (1) to what extent patients' wishes and the extent of any abnormality of brain performance influence the f requency with which >>nootropic<< drugs (those thought to affect brain activity, e.g. piracetam, pyritinol, or improve cerebral circulation, e.g. xanthine derivatives, Ginkgo biloba, secale alkaloids, calcium a ntagonists) are prescribed; (2) the medical. practitioner's expectatio ns of the effectiveness of such medications. Method: In a personal int erview, 145 family doctors and 14 neurologists in private practice in the Gottingen area of Germany (participation rate: 83.2% of those aske d to participate) were questioned about fictitious cases (case 1: mild memory problem with or without expressed wish for medication; case 2: moderate dementia, of Alzheimer or multi-infarct type). The previousl y arranged interviews, which took place in the doctors' practice rooms , consisted of standardized open questions to the written case reports . Results: Regardless of the wish of the patient and the extent and ty pe of the abnormal brain function at-tout 70% of all participating doc tors would prescribe those drugs, even though about 56% had doubts abo ut their effectiveness. About 28% expected a positive effect on brain performance. A nearly equal proportion of doctors would continue an ex isting drug regimen as would prescribe one. Conclusion: The prescripti on of the named group of drugs is influenced less by medical criteria than by factors which concern doctor-patient relationship.