Contenu du sommaire : Les médicaments : des prescriptions aux usages

About the medical mediation The norms of the psychotropic drugs use Facing the distress, the prescription of psychotropic drugs may offer an answer. Nevertheless, this prospect is conditioned by two phenomena: thus the value granted by the population to the medical support, and the effect exerted by the interaction between patients and general practitioners. These mechanisms, which we summarize by the concept of medical mediation, condition a therapeutic use which succeeds in becoming emancipated from the rules fixed by the sanitary institution, but also from the psychiatric recommendations or even from a rigorous inspection of the risks of dependence. The article underlines indeed, through the presentation of the public consuming and logics which organize the medical exchange, the incidence of alternate references, inherited of norms of identity and status. This organization builds a legitimacy of prescription centered on the inactive publics. It is at the origin of a field of care first dedicated to the management of inability, and thus to certain forms only of regularization of misfortune.

Psychotropic drugs and elderly: a same problem in France and Quebec. Review of literature The use of psychotropic medication is seen as a major problem related to public health in Europe as well as in North America. The limits between therapeutic and social functions of psychotropic medication have produced many controversies. In this debate, the case of the elderly is seen as a major issue. The aim of this article is to review the literature related to psychotropic medication use among the elderly in two French speaking societies, France and Quebec. First, we will focus on social and psychosocial characteristics of the elderly users in both countries. Then we will summarize the results of studies about adverse effects, addiction and other risks related to the long term use of psychotropic drugs by older people. Finally we will provide an analysis of social and cultural determinants of psychotropic drug utilization among the elderly by emphasizing the importance of physician/patient relationship and the rationale underlying prescribing behaviors.

« Calming the nerves »: self-medication, compliance and dependence in taking psychotropic medications Interviews concerning medicine cabinets in the home, conducted with retired persons and/or people living in rural areas, in lower Normandy (France), and ail mentioning psychotropic medication, are analysed from the standpoint of profane categories. In these interviews medications « for nerves » appear to stand apart from other medicines, a position which is confirmed by an analysis of the respondents' discourse. In this region where ethnological investigation has not revealed traditional remedies for the ailments that are currently treated by these medications, treatment « for nerves » falls into the category of everyday hygiene rather than being seen as medical. Reducing dépression to a « nerve sickness » avoids any involvement of psychiatry. This categorisation has an impact on self-medication, on compliance and dependence in relation to these medications, and provides insight into the problems raised by consumption of certain psychotropic medications in our country.

To take a pill, to take a stand: arguing about medication on electronic patient discussion lists What role does medication play in patients' perception of their disease and their relations with doctors? This article draws on original material: patients' contributions to discussion groups on the Internet. It highlights first the wide variety of considerations taken into account by patients in their discussions on medication and, second, the existence of relations with medication peculiar to the disease in question. In the three cases studied (cancer, Parkinson's disease, and fibromyalgia), we see how, through medication, the disease, patient and medication are redefined in relation to varied elements such as the organization of health care, the sharing of competencies between doctors, the state of knowledge on the disease and its treatment and, lastly, the very nature of treatments.