Psychiatric Drugs Prescribed Largely for Psychiatric Illness

For the most part, US office-based physicians prescribe psychiatric medications for psychiatric conditions, according to the results of a survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), part of the US Department of Health and Human Services.

Antidepressants and other psychiatric drugs are some of the most widely prescribed drugs in the United States, yet few studies have comprehensively analyzed the conditions for which these medications are prescribed, until now.

Tami L. Mark, PhD, from Thomson Reuters analyzed data from the 2005 National Disease and Therapeutic Index, an ongoing survey of a nationally representative sample of about 4000 US office-based physicians conducted by IMS Health. The analysis focused on the diagnoses that served as the primary reason for prescribing antidepressants, antipsychotics, and anxiolytic medications but did not evaluate clinical appropriateness of the drugs in these categories.

Although there has been concern about off-label use of some of these medications, a statement from SAMHSA notes that this study did not evaluate whether these drugs were used on- or off-label but did find that in most cases the prescription was for a psychiatric condition.

According to the new report, published in the April 1 issue of the journal CNS Drugs, antipsychotic drugs were prescribed for psychiatric conditions 98.9% of the time, most commonly mood disorders such as depression and bipolar disorder (39.0%) and schizophrenia or other psychotic disorders (34.5%). Roughly 7.4% of antipsychotic prescriptions were for cognitive disorders such as delirium and dementia (7.4%), 5.5% for anxiety, and 5.7% for attention-deficit/conduct-disruptive behavior disorders. Autism comprised 2.3% of antipsychotic prescriptions.

The study also found that 92.7% of antidepressant prescriptions were for psychiatric conditions, primarily mood disorders (eg, depression, 65.3%) followed by anxiety disorders (16.4%), which together comprised 81.7% of all antidepressant prescriptions.

Of the total number of antianxiety drug mentions, 67.7% were for psychiatric conditions, most commonly anxiety disorders (39.6%) followed by mood disorders (18.9%). Twenty-eight percent of antianxiety drug prescriptions were for nonpsychiatric diagnoses, including anxiety related to medical interventions (6%), allergic reactions (4%), and back problems (2.5%).

“From this study it seems clear that psychiatric medications are for the most part being prescribed for treating people with psychiatric conditions,” SAMHSA administrator Pamela S. Hyde, JD, noted in a prepared statement. “Yet, as clinicians broaden their use of psychiatric medications to a variety of mental illnesses, research and education are needed to ensure that the uses are appropriate.”

“This research provides a broad view of the nature of psychoactive medication prescribing, which may serve as a guide to future research, policy, and education about these medications, their perceived benefits and risks, and their uses,” Dr. Mark concludes.

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Megan Brooks
Medscape Medical News