한 종합병원에서의 향정신성 약물처방의 경향

Pattern of Psychotropic Prescription in a General Hospital

To study on the change in prescription pattern of psychotropic drugs for last 26 years, the medical records were reviewed in 100 inpatients who were randomly selected from total admitted patients to Severance Hospital, Yonsei University in each year of 1958， 1964， 1974， and 1984. The results showed that almost over thirds of the patients had been given psychotropic medications in each period, that is 69% in 1958，76% in 1964，75% in 1974 and 63% in 1984， the mean being 70.7%. Particularly the number of patients given day time medications for only psychotropic purpose has been gradually increased from 23% in 1958 to 37% in 1984. As time proceeds, the kinds of prescribed drugs had been expanded. The number of patients given benzodiazepine derivatives had been increased from 0% in 1958 to 48% in 1984, as newer derivative compounds had been added to or replaced classical ones. Antidepressants were added in 1974 and then newer second generation antidepressants later in 1984. However, the number of patients given neuroleptics were rather few and had not been increased so much, while those given barbiturates either for psychotropic purpose or as hypnotics had been decreased from 56% in 1958 to 11% in 1984. In spite of these changes, the psychiatric consultation had not been so frequent as psychotropic medication. These changes of precription pattern seem to follow the trends of the decline of old drugs and introductions of newer ones and seems to reflect partly the sale promotion of particular drugs and psychiatrists，recommendation through consultation services. The increasing prescription of benzodiazepines presents a serious problem of possible abuse and misuse. In the light of these findings, the role of psychiatrists in the general hospital were discussed.