Angell [1] questioned the theory that reduces the explanation of mental disorders to simple biochemical imbalances, and how the strong interests of the pharmaceutical industry perpetuate this model, extend the diagnostic categories of mental illness, leading to increased consumption of psychotropic drugs worldwide. His work was done on the basis of research conducted by Kirsch [2], Whitaker [3], and Carlat [4]. Kirsch [2] raises the question of whether antidepressants actually work and tests their effectiveness. Whitaker [3] put in doubt whether psychotropic drugs are better or result worse for general health. Carlat [4] highlights that the alliance between psychiatry and the pharmaceutical industry must be considered to determine mental illness.

These three authors warn that drug companies have not only begun to determine what can be considered mental illness and how it should be diagnosed and treated, but they have also launched measures of abusive and aggressive sale of psychoactive drugs, both legal and illegal [1].

The authors question the theory that mental illness is caused by a brain chemical imbalance that drugs can correct. According to Whitaker [3], patients diagnosed with schizophrenia, depression, or other psychiatric disorders do not have such chemical imbalances prior to drug treatment, but, once treatment is established, their brain begins to function abnormally. Meanwhile, Carlat [4] argues that this theory is a myth that does destigmatize mental illness. Kirsch [2], who conducted focused research on depression, concludes that the traditional account of depression in the brain is simply wrong [5].

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was criticized by various authorities both before and after it was formally published. Critics assert that many DSM-5 revisions or additions lack empirical support; inter-rater reliability is low for many disorders; several sections contain poorly written, confusing, or contradictory information; and the psychiatric drug industry unduly influenced the manual’s content. Various scientists have argued that the DSM-5 forces clinicians to make distinctions that are not supported by solid evidence, distinctions that have major treatment implications, including drug prescriptions and the availability of health insurance coverage. General criticism of the DSM-5 ultimately resulted in a petition signed by 13,000 psychiatrists, and sponsored by many mental health organizations, which called for outside review of the document [5, 6]. Subsequently, Cosgrove et al. [7] unveiled the existence of a relationship between the principal investigators of clinical trials, members of the panel for DSM-5 and the pharmaceutical companies, concluding that although there is an increase in transparency, through the registration of clinical trials and mandatory disclosure policy, it is not sufficient to prevent the biases in the process of revising the DSM, or clinical intervention decisions for DSM disorders.

The pharmaceutical industry has extended traditional diseases such as depression, and contributed to an expansion of mental health problems amenable to treatment, including neighboring situations to normality, such as shyness or hyperactive behavior in children [8].

In regard to children, before the DSM-5, Vasen [9] noted that an epidemic of improper names both in the clinic and in the classroom has arisen, which extends the range of children with labels and psychopharmacological medication inadequate, producing medicalization and pathologization of an age group as vulnerable as the children.

The problems of anxiety and depression are one of the main reasons for visits to a primary care physician. The current economic crisis has greatly increased in prevalence, and is expected that by 2020 will constitute the leading cause of disability worldwide [10].

A psychotropic drug is defined as any natural or synthetic substance, capable of influencing the psychic functions by their action on the central nervous system, and psychotropic drugs as any pharmaceutical product containing psychotropic substances, used as an object of psychological or neurological treatment of the disorders of the nervous system [11].

Psychoactive drugs are drugs that improve, reduce, and/or mitigate the symptoms of mental illness. They are primarily used to treat three types of alterations: schizophrenia and other psychoses, depression and mania (i.e., mood disorders), and the pictures produced by excessive anxiety or distress.

Psycholeptics have depressant properties of mental activity and include antipsychotics, hypnotics, anxiolytics and sedatives, which are commonly, used for the treatment of psychosis and anxiety disorders. The psychoanaleptics are stimulant drugs that include antidepressants, psychostimulants used to treat attention deficit disorder or attention deficit hyperactivity disorder, and nootropics and drugs against dementia [12].

According to the World Health Organization [14], the rational use of drugs (RUD) is that the patient receives the appropriate medication to their clinical needs, in doses corresponding to their individual requirements, for an adequate period of time, and at the lowest cost to himself and his community.

Furthermore, according to Mordujovich [15], the RUD is the application of the science knowledge backed by the evidence, quality, effectiveness, efficiency, and safety for the selection, prescribing, dispensing, and use of a particular medication when necessary and appropriate to a health problem, with the active participation of the patient enabling adherence and monitoring of treatment.

However, presently the RUD concept, promulgated at the conference in Nairobi, is being left unused to discuss prescription prudent, safe, or conservative, that means first prescribed under the principle of “primum non nocere”. RUD is still used to define good prescribing practices; however, according to Albert Figueras [16], the prescription is far from a rational act, but is not in itself good or bad: just being rational is not the goal [17].

According Turabian and Pérez- Franco [18], the requirement is to “be useful for practice and patients”. Beyond scientific rationality or resource management, the social event that involves the act of prescribing within a clinical context and genuine is considered, which is an encounter between persons and has a convenient, unique, and subjective sense.

Therefore, the requirement involves a commitment, where the former is to not do damage, to be honest, to know the limits and risks to which we are willing to go, and to share the uncertainties, mixing equal parts of art, values, and science with humility and humanity [17].

When considering psychotropic drugs, their rational use is based on helping the patient in the best possible way, taking into account the resources of the patient and the healthcare institution. It involves getting the best effect with the least number of drugs, during the shortest possible time, at a reasonable cost, which is essential to assess the willingness of the patient to take the medication.

The Argentine Union of Pharmacists and Biochemists estimated that the misuse or abuse of drugs causes 100,000 hospitalizations and about 22,000 deaths per year, especially in people over 65 years of age. The report estimates that 40 % of the population uses sedatives and stimulants without a prescription.

From the classical psychiatry there is a tendency to avoid anxiolytics prescription. It is recommended to use them with care, not exceeding 30 days because of their well-known addictive properties. The phenomena of tolerance have been reported, and it implies more doses for the same effect [13].

The use of drugs has been trivializing, particularly in the case of some psychoactive drugs such as anxiolytics. They have come to be used as a defense against the threats of everyday life.

People admit taking these medications to sleep, get some quiet, to overcome the stress of a divorce, the pressures generated by their children, or job uncertainty. They are also used to reduce anxiety or depression, or to not be sad. Everyone is responding to the emotional hazards of the day with their own drug. Currently, society is not allowed to experience sadness, much less tolerate the situation of unease.

In general, self-administered psychotropic drugs work as a magical remedy and is not recognized as part of a treatment. Many people take it as they see fit. Typically, when a medication is prescribed for a short time, the patient tried it to restore emotional balance.

Given that society accumulates daily stress, and that anxiolytics are relatively inexpensive and apparently safe and effective, people trust, and seek quick solutions. Unfortunately, when it is not used as a treatment, this anxiolytic is not needed.

Anxiety is an emotional reaction to a perceived threat or danger. People feel that it lacks the resources to address them. There is a big difference between psychic resources and the individual responsiveness to the demands of society, and that difference is covered with quick fixes such as anxiolytics [13].

Medicalization is defined as the process by which nonmedical problems are treated as medical problems, usually in terms of disease or disorder [19]. Medicalizing the human condition involves applying a diagnostic label to unpleasant feelings or undesirable behaviors that are not clearly abnormal, but are placed in a difficult area to distinguish that occupy a range of experiences that often are inescapably attached to being a person [20].