America's Use of Psychotropic Medications on the Rise

Caroline Cassels

November 17, 2011

November 17, 2011 — A new report shows that 1 in 5 adult Americans took at least 1 psychiatric medication in 2010. In women, the statistic was 1 in 4.

The report, issued by Medco Health Solutions, which conducted the study, analyzed trends in mental health medication usage among approximately 2.5 million insured Americans, comparing use of antidepressants, antipsychotics, attention-deficit/hyperactivity disorder (ADHD) drugs, and antianxiety treatments from 2001 to 2010.

"Over the past decade, there has been a significant uptick in the use of medications to treat a variety of mental health problems; what is not as clear is if more people — especially women, are actually developing psychological disorders that require treatment, or if they are more willing to seek out help and clinicians are better at diagnosing these conditions than they once were," David Muzina, MD, a psychiatrist and national practice leader of the Medco Neuroscience Therapeutic Resource Center, said in a release.

"Women are generally more frequent users of healthcare, but they may also be bearing the emotional brunt of a decade that started with the horror of 9/11 and since has seen several wars and economic turmoil," he added.

Antidepressants were the most commonly used medications, with more than 20% of women receiving them. Antianxiolytics were also widely used by women, at almost twice the rate of men. The greatest use was in women aged 45 to 65 years, 11% of whom were taking an antianxiety medication in 2010.

Greater Use of Atypicals in Kids

Many more boys than girls are prescribed treatments for ADHD, but in adulthood the number of women taking an ADHD medication trumped use by men. The report shows that women's use of these medications was 2.5 times higher in 2010 than in 2001. The most striking jump in the use of these drugs was seen in 20- to 44-year-old-women, where it rose 264% in 10 years.

Although women are the predominant users of atypical antipsychotics, the study revealed a huge upswing in use of these drugs among men as well, quadrupling in men aged 20 to 64 years since 2001.

"The overall results, that substantially more individuals are on psychotropic medications, [are] sobering and important. Understanding the reasons for this increase is the next critical goal," said Martha Sajatovic, MD, professor of psychiatry at Case Western Reserve University School of Medicine and Director of the Neurological Outcomes Center, University Hospitals Case Medical Center, Cleveland, Ohio, in the press release. "The healthcare implications could be substantial, given increasing financial constraints on individuals and healthcare funding entities."

Psychotropic medication use was also increased in children, although antidepressant use in children dropped substantially, a trend that was largely attributed to 2004 warnings issued by the US Food and Drug Administration about an increased risk for suicidal ideation. The analysis also showed a drop in ADHD medication use in children since 2005.

However, the number of children receiving atypical antipsychotics doubled from 2001 to 2010, a phenomenon Dr. Muzina said should raise a red flag.

"The fact that more children are being treated with atypicals is concerning given that substantial weight gain is highly associated with the use of these drugs in this population, putting children at risk for diabetes and heart disease-related conditions. When using these drugs, children need to be monitored on a frequent basis to prevent against these serious health risks," he said in the release.

Older Women and Antidepressants

Adults aged 20 to 44 years showed the greatest spikes in the use of psychotropic medications over the course of the decade for 3 of the 4 medication categories.

In addition to more than tripling their use of ADHD medications since 2001, the 20- to 44-year-old group also saw significant spikes in their use of atypical antipsychotics (248%), and their use of antianxiety treatments was up nearly 30%. From the start of the decade, the number of men in this demographic receiving a mental health medication grew at a faster clip than their female counterparts: up 43% vs 25%.

Older women are most likely to use an antidepressant, with nearly 24% of those older than 64 years taking these medications. They also experienced a 40% increase in antidepressant use during the 10-year study period.

Use of atypical antipsychotics also increased among older women, up 88% since the start of the decade. However, there was 47% drop in their use of antianxiolytics.

A review of regional use of psychotropic medications found that the highest use was in the east south-central United States, which is part of the "diabetes belt" and includes Tennessee, Kentucky, Mississippi, and Alabama.

The lowest rates of use (15%) were seen in the east north-central region, which includes Indiana, Ohio, Wisconsin, and Michigan.

"Studies have shown that people with diabetes do have higher levels of depression and anxiety disorders, so it's not surprising that we see great use of mental health-related medications in the 'diabetes belt' region," said Dr. Muzina.


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