Editorial

The patient's perspective on medicines in mental illness

BMJ 2003; 327 doi: 10.1136/bmj.327.7419.824 (Published 9 October 2003)
Cite this as: BMJ 2003;327:824

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  1. Mike Shooter, president
  1. Royal College of Psychiatrists London SW1X 8PG

    Drug treatment is only a part of what the patient needs

    Worldwide 40 antipsychotic preparations are available and twice as many antidepressants. As a patient with a recurrent depressive disorder myself it would be comforting to think that choice of treatment is based on a concordance between the patient's wishes and the doctor's advice. In reality it will reflect the many factors that affect their relationship—medical attitudes; the way information is presented; the capacity of patients to understand this information and to relate it to their condition; health service, social, and commercial pressures. Not surprisingly, Cochrane reviews of interventions to improve “adherence” show findings that are inconsistent or complex.1 2 Adherence can only be improved by mutual respect.

    The benzodiazepine story

    First introduced to the United Kingdom in the 1960s as a “safe” alternative to barbiturates

    Used as a panacea for anxiety—in everything from wrecked marriages to redundancy

    31 million NHS prescriptions per year at the height of their popularity, enough to sedate three out of every four adults in the land

    Experts voicing warnings about addiction and side effects by the early 1970s. Fought by drug companies and ignored by doctors

    Not until 1988 that the Committee on Safety of Medicines took decisive action. Users banded …

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