Thomson Reuters Study Offers New Insight on How Physicians Prescribe Psychiatric Drugs

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Mar 22, 2010, 11:00 ET

ANN ARBOR, Mich., March 22 /PRNewswire/ -- A study published today outlines the medical conditions that U.S. physicians reported treating with psychiatric drugs.

The research was conducted by Thomson Reuters, sponsored by the federal Substance Abuse and Mental Health Services Administration (SAMHSA), and published in the journal CNS Drugs.

Psychiatric medications are one of the most widely prescribed categories of drugs in the nation, but few studies have comprehensively examined the types of illnesses being treated with these medications. There has been a great deal of interest and some concern about the "off-label" use of psychiatric drugs -- that is, their use for medical conditions not included in their Food and Drug Administration-approved labeling. In most instances it is legal and a common practice for physicians to prescribe drugs off-label, even though less may be known about a drug's risks and benefits for an unapproved indication.

This study did not evaluate whether drugs were prescribed for on- or off-label use, but it reveals that in the vast majority of cases physicians are prescribing psychiatric medications for patients with psychiatric conditions. These medications -- especially anti-anxiety drugs -- are also sometimes prescribed to treat other conditions.

"From this study, it seems clear that psychiatric medications are for the most part being prescribed for treating people with psychiatric conditions," said SAMHSA Administrator Pamela S. Hyde, J.D. "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."

The study looked at the prescription patterns for three major types of psychiatric drugs: antipsychotic drugs, antidepressant drugs, and anti-anxiety drugs, but did not evaluate clinical appropriateness per se.

"The information presented in this study can serve as a guide to future research, policy, and education about these medications, their perceived benefits and risks, and their uses," said lead study author Tami L. Mark, PhD., director of analytic strategies at Thomson Reuters.

The study found that antipsychotic drugs were prescribed for psychiatric conditions 99 percent of the time, including mood disorders (39 percent), schizophrenia or other psychotic disorders (35 percent), cognitive disorders such as dementia (7.4 percent), anxiety (6 percent), and attention-deficit/conduct-disruptive behavior disorders (6 percent).

In terms of antidepressant drugs, the study found that 93 percent of prescriptions were for psychiatric conditions, primarily mood disorders (65 percent), anxiety (16 percent), schizophrenia, and other psychotic disorders (2.6 percent). Non-psychiatric diagnoses for which antidepressants were prescribed included headaches (1.1 percent), connective tissue disease (e.g., fibromyalgia) (1 percent), and back problems (0.7 percent).

The study found that the majority of prescriptions written for anti-anxiety medication were used to treat psychiatric conditions (72 percent), although a significant percentage (28 percent) were used to for non-psychiatric diagnoses including anxiety related to medical interventions (6 percent), allergic reactions (4 percent), and back problems (2.5 percent).

The study analyzed data from the 2005 National Disease and Therapeutic Index, a nationally representative survey of about 4,000 U.S. office-based physicians conducted by IMS Health.

SAMHSA is a public health agency within the U.S. Department of Health and Human Services. Its mission is to reduce the impact of substance abuse and mental illness on America's communities.

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SOURCE Thomson Reuters