Why psychiatrists in India prescribe so many drugs

Abstract

Psychiatrists, though they occupy relatively high status positions, are nevertheless individuals whose motives and attitudes are in large part culturally determined and whose choices are culturally constrained. This paper examines cultural factors that may contribute to the tendency of psychiatrists at two general hospitals in northern India to rely heavily on multiple drug prescriptions and on electroconvulsive therapy (E.C.T.) in the treatment of their clients. What the author describes as an "epidemic" view of psychiatric pathology, the political economy of psychiatric care in India, the need to "sell" psychiatry as a legitimate kind of medicine by satisfying client expectations, and psychiatrists' relationship to other actors in India's pluralistic medical system are all presented as factors that encourage a reliance on pharmaceutical or somatic interventions in psychiatric settings.