Why do GPs prescribe psychotropic drugs when they would rather provide alternative psychological interventions?

Hypnotics, anxiolytic, and antidepressant drugs are the psychotropic agents most commonly prescribed by GPs. Despite current evidence and guidance, prescribing of these agents is often problematic for GPs and their patients, particularly when drugs are given for an inappropriate indication or for an excessive length of time. A study from France published in this issue,1 where a quarter of the adult population are on psychotropic drugs, reminds us that, despite national differences in clinical practice, this is an international problem with potentially alarming consequences for adverse outcomes, patient safety, and healthcare costs. At particular risk is the growing demographic group of older patients who often suffer from multiple morbidities and who are therefore subject to high levels of polypharmacy. Recognition of these alarming trends gives rise to questions about why psychotropic drugs are so often prescribed when other management options might be safer or more effective, why this issue persists despite doctors'(and patients') negative beliefs about drugs, and what might be done about it? Two articles in this issue offer some answers to these questions.1, 2 Lasserre and colleagues' used a cross-sectional survey method to study French GPs' opinions about psychotropic prescribing for their older patients. Reducing reliance on psychotropic medication was seen as desirable with possible barriers to implementation being a perception or experience that patients or their carers would refuse alternatives, insufficiently developed services or funding for psychological therapies, and GPs' concerns about the adequacy …