An increase in health expenditures and consumption of medications in Turkey is an issue that comes up from time to time in both public and scientific circles in Turkey. Possible causes of this could be that people might have more awareness about mental illnesses and that more referrals would be made to physicians. However, when we look at the drug consumption in terms of units and the number of new and total psychotropic drug prescriptions, the emerging figures reveal the likelihood of possibilities beyond possibility. The data on the astounding increase in the consumption of antidepressants stands out in particular. Drug consumption is growing exponentially in Turkey according to the 2012 healthcare report of the Intercontinental Marketing Services (IMS)., Unit sales has increased by approximately 120% from 2003 to 2008 and 159% from 2003 to 2012. This increase is also observed in the use of antipsychotics; unit sales of antipsychotics was 7.20 million boxes in 2007 and it has increased by approximately 68.8 % in 2012. The distribution of the number of prescriptions written by other specialties reveals that family practitioners have prescribed more antidepressants in the last two years than the psychiatrists. It appears that there is an inconsistency between unit sales and the incidence of psychiatric disorders in the country, which leads to the conclusion that some of these medications were prescribed unnecessarily. There are many different antidepressants available with different mechanisms of action and only a specialist would determine which medication is appropriate for the patient and decide on the dosage as well as the length of treatment. Just like any other medication, antidepressants can also have serious or life-threatening side effects. Consideration of the drug interactions is an important issue in patients taking other medications and it can lead to serious problems especially in the elderly, who use multiple medications. One needs to be aware that it is not possible to treat depression using only antidepressants. The great factor that lies in the formation of this situation, is the health care statement indicating that antidepressants can be prescribed by all the physicians regardless of their specialty. In addition, there is the illusion within the longstanding health care system that neurologists are authorized for the use of psychotropic medications as much as the psychiatrists. Even if there are several psychiatrists in a hospital, 20% of the psychotropic medication prescriptions are issued by neurology. According to the data, neurologists initiate a psychotropic treatment in half the number of patients’ who are seen by psychiatrists. In the current residency programs, neurologists do not receive any psychiatric training beyond the residency rotation program of 3 months that they are expected to complete. Allowing physicians from other specialties with only 3 months of psychiatric training, to treat patients like a psychiatrist have led to boundary violations and contributed to an increase in unnecessary use. The situation is obvious and needs to be urgently rectified. There should be regulations placed regarding medications to be
prescribed only by psychiatrists and not other specialties and psychotropic medications not being sold without prescription. The rational use of drugs will prevent unnecessary drug expenditure and preventing those, who are not psychiatrist from prescribing psychotropic medications and putting individuals at-risk.