Neuroleptic drug use in nonpsychiatric departments of a Dutch university hospital.
During a 1-year period, neuroleptic drug utilization was assessed in nonpsychiatric departments of a Dutch university hospital in defined daily doses (DDD), DDD per 100 patients and per 100 bed days. Substantial divergence was found among the nonpsychiatric departments with respect to the quantity as well as the types of neuroleptic used, but there was no relationship between psychiatric consultations and neuroleptic use. In semistructured interviews, the senior consultant at each department stated that neuroleptics were used not only for the treatment of behavior disorders but also for nonpsychiatric indications, such as pain, nausea, and hiccups. In addition, specific neuroleptics were considered to be appropriate for the treatment of specific indications, but the doses anticipated to be effective were in many cases well below the DDDs. It is concluded that substantial quantities of neuroleptics are prescribed for nonpsychiatric use. This is remarkable, because very little is known about nonpsychiatric indications and the effects of neuroleptics, including the unwanted side effects, in patients who are somatically ill.