Mental health policy and practice across Europe: an overview

Psychopharmaceuticals in Europe 171
Figure 7.2 Prescriptions for psychoactive drugs (millions) in the United Kingdom
1960–1982
Source: Approximate figures, redrawn from Ghodse and Khan, 1988, Figure 1, derived mainly
from the Office of Health Economics, London.
individuals, and in extreme cases, the cause of their homicidal conduct. It
seemed that from this time on, an open psychiatric system would be fundamentally
dependent on the belief in the therapeutic and management possibilities
of psychopharmacology.
Trend data from 1980 to 2000 (see Table 7.23) show that over the 20 years
from 1980, the total number of prescription items dispensed in the four main
classes of drugs used for psychiatric conditions – hypnotics and anxiolytics,
antipsychotics, antidepressants and stimulants, rose from about 34.5 million
items to about 44.5 million – a growth of almost 30 per cent. However, this
overall growth disguises the fact that, from 1980 to 1994, the number of prescription
items actually declined, largely as a result of a reduction in prescribing
for hypnotics and anxiolytics – the minor tranquillizers and sleeping pills whose
use had caused concern. The figures show a decline in prescriptions for hypnotics
and anxiolytics of about 32 per cent (from about 24.5 million prescription
items to about 16.5 million prescription items per year) matched by a rise in
prescriptions for antidepressants of about 200 per cent (from about 7.5 million
prescription items to around 22 million prescription items per year). 12 These
figures show a relatively small increase in the number of prescription items
dispensed for the two drugs used to tread ADHD – dexamphetamine and methylphenidate
– from just over 111,000 items in 1980 to just over 260,000 in
2000. However, this figure is misleading. In terms of quantity, the rise has been
almost fivefold, from 6,280,790 standard units in 1980 to 29,358,340 in 2000,
and almost two-thirds of this growth is accounted for by Ritalin which has
grown at a great rate since its introduction in 1991. The net ingredient cost of