[Towards sustainable psychiatry - Eco-prescription in action]

While environmental concerns are becoming increasingly important in the field of health, drug prescription remains a blind spot in the ecological transition. In psychiatry, antidepressants are often prescribed for long periods, sometimes outside of approved indications, and their carbon impact is rarely taken into account. This article proposes the concept of eco-prescribing, defined as the choice of treatments with a lower environmental footprint and equivalent clinical efficacy. Using data from the Ecovamed® database, we compare the carbon footprint of several antidepressants at equivalent doses and show that their impact varies by a factor of two. We discuss the practical implications of these results for psychiatrists, emphasizing that eco-prescribing does not replace clinical reasoning, but complements it. Finally, we broaden the discussion to other levers of sustainable care: remote psychotherapy, psychonutrition, physical activity, and supervised use of honest placebos. Far from being marginal, environmental criteria could become a simple benchmark to guide therapeutic choices in psychiatry concerned with sustainability.