International Journal of
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Review Article Volume 10 Issue 2
Rethinking psychotropic prescribing in primary care: a “pause before prescribing” model
Marcello Maviglia
Received: April 01, 2026 | Published: April 15, 2026
Citation: Maviglia M. Rethinking psychotropic prescribing in primary care: a “pause before prescribing” model. Int J Fam Commun Med. 2026;10(2):78-81. DOI: 10.15406/ijfcm.2026.10.00417
Abstract
Primary care has become the principal site of psychotropic prescribing, often under conditions of limited time, diagnostic uncertainty, and constrained access to psychosocial resources. In this environment, emotional distress is frequently misinterpreted as psychiatric disorder, and medication becomes the default response to complex social, interpersonal, and structural challenges. This pattern contributes to diagnostic inflation, the medicalization of existential suffering, and exposure to iatrogenic harms, including withdrawal syndromes, polypharmacy, and long‑term functional impairment. This article proposes a “Pause Before Prescribing” model to restore intentionality in primary care. Intentionality refers to the clinician’s capacity to act with deliberation rather than being carried by time pressure, diagnostic habits, or institutional expectations that each visit must culminate in a concrete intervention. Reclaiming intentionality creates space for listening, contextualizing, mobilizing supports, and engaging resources—including peer specialists—before turning to medication. The model emphasizes contextual assessment, attention to social determinants, nonpharmacologic approaches, transparent risk discussions, time‑limited prescribing, principles of safe reduction, and the involvement of peer support specialists. Rather than rejecting medication, it situates prescribing within a broader biopsychosocial and public health framework, promoting safer, culturally grounded, and recovery‑oriented care.
Keywords: psychotropic prescribing, primary care, deprescribing, withdrawal, peer support, cultural psychiatry
©2026 Maviglia. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.