KARACHI, Sept 4: A number of pharmaceutical companies have been unwisely promoting tranquilisers as essential medicine for the peace of mind without taking into consideration the hazards of careless use of sedatives in primary care.
These views were expressed at a seminar on the use of psychotropic medication in primary care, recently organised by the Aga Khan University under its continued medical education programme for primary care physicians and specialists.
Dr Ehsan Syed, a consultant psychiatrist, said that extra care should be taken while prescribing sedatives as injudicious use of medications such as lithium could cause damage to thyroid and kidneys if not monitored properly.
“Mood stabilisers should not be used for minor psychiatric conditions such as anxiety or depression and should be reserved for cases which are more severe such as manic depression, also known as bipolar disorder,” he said.
He said that while treating a patient with a bipolar disorder requiring mood stabiliser a primary care physician must consult the treating psychiatrist about the dosage and potential drug to drug interactions.
Speaking on depression, Dr Naim Siddiqi, an assistant professor at the AKUH, said that Pakistan was one of those countries where the prevalence of depression was the highest.
He said that antidepressants were now available, but the problem was that many people discontinued them permanently due to their ignorance that these medicines started showing their beneficial effects after the first 10 to 15 days.
The treatment for depression must
continue for at least a year and the medicines should be gradually tapered off, he said.
Talking about the trend of self-prescription for tranquilisers, Dr Haider Ali Naqvi, informed the audience about the hazardous side-effects of these medicines.
“By a conservative estimate around seven to ten million urban dwellers in Pakistan consume these medications regularly. According to one estimate, psychotropic drug sales in Pakistan during June 2003-04 touched Rs2.76 billion mark and the total sale of tranquilizers and hypnotics reached Rs1.36 billion during that period with a rising trend of 18 per cent and 137 per cent respectively from previous year”, he said.
He further said that in developed countries, benzodiazepine overdose was the most common way of self-poisoning among the substance induced suicidal attempts, accounting for about 40 per cent of the total.
He criticised the role of pharmaceutical companies that had been marketing these tablets as ‘absolute recipe for peace of mind’ for the sake of their business, which, according to him, should be discouraged.
Dr Syed Ahmer stressed the need for avoiding anti-psychotics for the use of symptoms like anxiety, depression without psychotic symptoms or insomnia.
As the name suggests, these should only be used for the treatment of a psychotic illness, such as schizophrenia, manic psychosis, depression with psychotic symptoms etc, he added.
