Patterns of neuroleptic drug prescription: a national cross-sectional survey of a random sample of French psychiatrists

Aims To describe the psychiatric indications of neuroleptics (especially th e relative share of schizophrenic and other psychotic disorders) and the us age patterns of these drugs (dose, duration, coprescriptions). Methods A one-day national cross-sectional survey in a random sample of 723 French psychiatrists was carried out in 1996. Each psychiatrist was asked to complete a standardized questionnaire for the first three patients seen the day of the survey to whom at least one neuroleptic was prescribed (init iated or renewed). Results One thousand seven hundred and fifty-four questionnaires were retur ned. Three quarters of the patients (74%) were psychotic (664 with schizoph renia, and 636 other psychosis), 19.3% were depressive and 6.7% had other p sychiatric disorders. Phenothiazines were the most often prescribed (40.8%) , followed by butyrophenones (22.5%), benzamides (15.8%), other neuroleptic s (14.8%) and thioxanthenes (6.1%). Among schizophrenic subjects, an averag e number of 1.54 (95% CI: 1.50-1.60) neuroleptics were prescribed per patie nt, compared with 1.4 (95% CI: 1.32-1.41) and 1.2 (95% CI: 1.14-1.23) in ot her psychotic and depressive subjects, respectively. Regardless of the indi cation, non-neuroleptic psychotropic drugs were coprescribed in 75.4%, main ly benzodiazepines (75.7%). Adjuvant drugs used in prevention or treatment of side-effects were coprescribed in 46.7%, mostly anticholinergic antipark insonians (86.1%). Conclusions Neuroleptics are mainly prescribed for psychotic disorders and especially schizophrenia. However, current recommendations are not always f ollowed.