Psycho-social aspects of treatment with long-acting neuroleptics in Spain

In Spain, there is no national pharmaceutical industry in the field of neuroleptics and restrictive legislations tend to limit the marketing of new drugs. Only five long-acting neuroleptics (LAN) are available: fluphenazine enantate and decanoate, pipotiazine undecylate and palmoate, thioridazine "sustained-release"; LAN consumption represents 15% of all neuroleptics. Despite the numerous advantages of LANs, discussed by the author, the organisation of medicine and psychiatry in Spain, among others constant institutional "psychiatric revolutions", interferes with therapeutic decisions and follow-up: no sound empirical reports on factors influencing the prescription of drugs, stable plasma levels than repeated oral doses), difficulties for specialists to follow-up patients after their discharge from hospital. Cultural variables possibly play a role too, such as the declining french and german influence on spanish psychiatry and the increasing proportion of younger "antipsychiatric" doctors. The authors gives a detailed account of the psychiatric curriculum at the pre- and postgraduate levels.