Benzodiazepines prescription in Dakar: a study about prescribing habits and knowledge in general practitioners, neurologists and psychiatrists

• Published in: Fundamental & clinical pharmacology 2006-06, Vol.20 (3), p.235-238
• Main Authors: Dièye, Amadou Moctar, Sylla, Mbaye, Ndiaye, Awa, Ndiaye, Mamadou, Guata Yoro, Sy, Faye, Babacar
• Format: Article
• Language: English
• Subjects: Anxiety - drug therapy; benzodiazepines; Benzodiazepines - pharmacokinetics; Benzodiazepines - therapeutic use; Biological and medical sciences; Bromazepam - pharmacokinetics; Bromazepam - therapeutic use; Dakar; Developing Countries; Drug Prescriptions; Drug Utilization; Education, Medical, Continuing; Health Care Surveys; Health Knowledge, Attitudes, Practice; Humans; Medical sciences; Neurology; pharmaco-epidemiology; Pharmacology. Drug treatments; Physicians, Family; Practice Guidelines as Topic; Practice Patterns, Physicians; Prazepam - pharmacokinetics; Prazepam - therapeutic use; prescription; Psychiatry; Senegal; Sleep Initiation and Maintenance Disorders - drug therapy
• ISSN: 0767-3981; 1472-8206
• DOI: 10.1111/j.1472-8206.2006.00400.x

Benzodiazepines are relatively well‐tolerated medicines but can induce serious problems of addiction and that is why their use is regulated. However, in developing countries like Senegal, these products are used without clear indications on their prescription, their dispensation or their use. This work focuses on the prescription of these medicines with a view to make recommendations for their rational use. Benzodiazepine prescription was studied with psychiatrists or neurologists and generalists in 2003. Specialist doctors work in two Dakar university hospitals and generalists in the 11 health centres in Dakar. We did a survey by direct interview with 29 of 35 specialists and 23 of 25 generalists. All doctors were interviewed in their office. The questionnaire focused on benzodiazepine indications, their pharmacological properties, benzodiazepines prescribed in first intention against a given disease and the level of training in benzodiazepines by doctors. Comparisons between specialists and generalists were made by chi‐square test. Benzodiazepines were essentially used for anxiety, insomnia and epilepsy. With these diseases, the most benzodiazepines prescribed are prazepam against anxiety and insomnia and diazepam against epilepsy. About 10% of doctors do not know that there is a limitation for the period of benzodiazepine use. The principal reasons of drugs choice are knowledge of the drugs, habit and low side effects of drugs. All generalists (100%) said that their training on benzodiazepines is poor vs. 62.1% of specialists, and doctors suggest seminars, journals adhesions and conferences to complete their training in this field. There are not many differences between specialists and generalists except the fact that specialists prefer prazepam in first intention in the insomnia treatment where generalists choose bromazepam. In addition, our survey showed that specialists’ training in benzodiazepines is better than that of generalists. Overall, benzodiazepine prescription poses problems particularly in training, and national authorities must take urgent measures for rational use of these drugs.