NEUROLEPTIC DRUG-USE IN NONPSYCHIATRIC DEPARTMENTS OF A DUTCH UNIVERSITY HOSPITAL

During a 1-year period, neuroleptic drug utilization was assessed in n onpsychiatric departments of a Dutch university hospital in defined da ily doses (DDD), DDD per 100 patients and per 100 bed days. Substantia l divergence was found among the nonpsychiatric departments with respe ct to the quantity as well as the types of neuroleptic used, but there was no relationship between psychiatric consultations and neuroleptic use. In semistructured interviews, the senior consultant at each depa rtment stated that neuroleptics were used not only for the treatment o f behavior disorders but also for non-psychiatric indications, such as pain, nausea, and hiccups. In addition, specific neuroleptics were co nsidered to be appropriate for the treatment of specific indications, but the doses anticipated to be effective were in many cases well belo w the DDDs. It is concluded that substantial quantities of neuroleptic s are prescribed for nonpsychiatric use. This is remarkable, because v ery little is known about nonpsychiatric indications and the effects o f neuroleptics, including the unwanted side effects, in patients who a re somatically ill.