Which Psychotropic Medicines are Preferred by Iranian Psychiatrists as the most Accessible Ones under Sanctions?

Background: Accessibility of medicines is one of the main building blocks of health. As a consequence of the decision of the US president to withdraw from the Joint Comprehensive Plan of Action, harsh sanctions were instigated on Iran. Legally, medicines were exempted from the sanctions. But in practice, this action has caused serious shortage of medicines including psychotropics in Iran. As a domestic solution, the impact of this shortage on the patients could be mitigated by distributing the most needed medicines in pharmacies closest to public and private psychiatric clinics to reduce patients’ sense of bewilderment. We tried to identify the top 10 psychiatric medicines for this purpose. Methods: Through semi-structured interviews with all the 384 reachable psychiatrists of Iran, face to face or by phone, we prepared a list of psychiatric medicines preferred as priority. Data were analyzed using X² for relationships with contributing factors and controlling for confounders. Results: Medicines were ranked, and we ended up with a final list of ten. Sertraline ranked first followed by sodium valproate and risperidone. Age and years of experience were correlated with preferences. Comparison with the sales market ranking showed that the latter is mainly influenced by benzodiazepines not prescribed by psychiatrists. Conclusion: We finalized a ranked list of psychiatric medicines useful for the food and drug administration of Iran to consider in distributing psychotropic medicines in the vicinity of public and private clinics. This will ease access and help in mitigating patients’ stress. Other medical groups can follow suit.