Prescriptions soar for psychotropic drugs

Nationwide, prescriptions for psychotropic drugs increased dramatically between 1985 and 1994.

The upturn in prescriptions has been spurred by the new generation of drugs like Prozac, researchers have found.

"There has been an enormous increase in research on mental disorders that has elaborated a much better understanding of how they come about and how to treat them more effectively," said Harold A. Pincus, M.D. Pincus is lead author of a new study in the Feb. 18 issue of The Journal of the American Medical Association.

Psychotropic medications-medications that have an effect on the mind-are among the most widely prescribed medications in the United States. As a class, they represented 8.8% of the prescription drug market in 1994, and their use has been increasing in recent years, according to information cited in the study.

Visits where depression was diagnosed almost doubled over the 10 years, from about 11 million to more than 20.4 million, researchers said.

More growth occurred in the prescribing of antidepressants than in any other category, from 30.4% to 45.2% of all psychotropic drugs, the researchers said. At the same time, tranquilizer prescriptions fell from 51.7% to 33%.

The researchers suggest that the structure of health care delivery and health care reimbursement may also be affecting the use of psychotropic drugs: "In many managed care organizations, the incentives of a capitated system would encourage primary care physicians to maintain responsibility for their patients with mental disorders, treat them efficiently with medications, and not refer them for specialty care."

In recent years, health officials have encouraged more recognition and drug treatment of depression, and campaigns have been waged to increase public and physician awareness of its prevalence.

However, there has also been a loud public outcry against using such drugs in nursing homes. Psychotropic medications and other prescriptions are often administered inappropriately in facilities, according to the Department of Health and Human Services.

In fact, nearly half of the nursing home pharmacists surveyed by department investigators indicated that residents receive medications that are not appropriate. PR