[The use of psychotropic drugs in prison (CP Madrid III)]

The use of psychotropic drugs in primary care has exponentially increased and prisons are no exception. These drugs are often prescribed in order to find therapeutic uses in the fields of personality disorders, addictions, and dysfunctional behaviours that have not been accepted as indications (compassive use). This study enabled us to make a detailed description of the use of psychiatric drugs at the Madrid III prison, a centre with one of the lowest levels of pharmaceutical expenditure in the region. For a two-week period, all prescriptions of psychotropic drugs were collected and registered along with data of several possible conditioning factors. 20.5% of the population was receiving some kind of psychiatric drug; 76% of those inmates undergoing treatment were receiving one or two psychotropic drugs; 65% were taking sedatives, 38% antidepressants and 27% antipsychotic medication. The total amount of psychotropics consumed was 9,840 DDDs, 46% of which were sedatives, 17% of those being antidepressants and the other 14% antipsychotics. The total cost of the fortnight's treatment was 5,379 euros, 72% of which was spent on antipsychotic medication. There are signs that compassive use of the latest generation of antipsychotics and antiepileptics, and the newer antidepressants are a main cause of the dramatic increase in cost, and cost efficiency has not always been clearly demonstrated. One of the key influencing factors on amount, type and cost of treatment was the prescriptor. An unexpected result was that of finding no relationship between age, nationality, grade or other individual variables and prescription of different kind of medication, with the exception of benzodiazepines.