Intra-city differences in psychotropic drug use: a Nigerian scene

In a study of prescribing practice in 3 psychiatric institutions in Lagos, Nigeria, patterns of psychotropic drug use were generally unsatisfactory in terms of poly-pharmacy, high frequency of daily multiple administrations and prolonged use of minor tranquillisers. These deficiencies were noticeable in one of the hospitals that had the lowest doctor:patient ratio with consequent greatest workload, employed the 'medical model' as its main practice-orientation and that bore responsibility for a large part of community psychiatric morbidity. The widespread use of anti-parkinsonian agents had some rationality in view of the grossly inadequate community-based facilities needed to control drug induced extra-pyramidal side-effects. Improving psychiatric services, through personnel training, sufficient funding and the realisation of the need for therapists to conform to acceptable rules of drug prescribing, would help tremendously to minimise the vagaries and anomalies of drug use observed.