(dailyRx News) Psychiatric medications are one of the most widely prescribed categories of drugs in the U.S., but not all those drugs are taken to help treat a mental health condition. Until now, though, there's been little data about the various ways physicians are prescribing them.
A new study from the Substance Abuse and Mental Health Services Administration (SAMHSA) aims to shed light on the different conditions health care providers across the U.S. treat with antipsychotics, antidepressants and anti-anxiety medications. SAMHSA is part of the U.S. Department of Health and Human Services. Its mission is to reduce the impact of substance abuse and mental illness on the nation's communities.
Few previous studies have comprehensively looked at the types of health issues being treated with psychiatric medications. The need for such information has grown, as there's been a great deal of interest about and even concern over how psychiatric drugs are being prescribed for medical conditions not approved by the FDA for those drugs. This relatively common prescribing practice is called off-label use and in most situations is legal. That said, off-label use of any type of medication can carry with it some level of risk because not much may be known about what benefits and side effects are possible for the unapproved use.
Although the SAMHSA study didn't specifically seek out whether the psychiatric drugs were prescribed for on- or off-label use, it does reveal that in most cases, physicians are prescribing these medications for patients with psychiatric conditions. Said SAMHSA Administrator Pamela S. Hyde, J.D., "From this study it seems clear that psychiatric medications are for the most part being prescribed [to treat] people with psychiatric conditions. 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."
Researchers who worked on the study examined the prescription patterns for three major types of psychiatric drugs: antipsychotic drugs, antidepressant drugs and anti-anxiety drugs. They didn't, as stated earlier, evaluate clinical appropriateness per se.
The researchers found antipsychotic drugs were prescribed for psychiatric conditions 99 percent of the time for these treatment purposes:
- Mood disorders -- 39 percent
- Schizophrenia or other psychotic disorders -- 35 percent
- Cognitive disorders, such as dementia -- 7.4 percent
- Anxiety -- 6 percent
- ADHD and other conduct-disruptive behavior disorders -- 6 percent
Ninety-three percent of prescriptions for antidepressants, the researchers found, were for psychiatric conditions:
- Mood disorders -- 65 percent
- Anxiety -- 16 percent
- Schizophrenia and other psychotic disorders -- 2.6 percent
Unlike antipsychotics, the researchers uncovered that antidepressants are prescribed occasionally for off-label uses. The diagnoses for which antidepressants were prescribed included the following:
- Headaches -- 1.1 percent
- Fibromyalgia -- 1 percent
- Back problems -- 0.7 percent
Although the SAMHSA study found almost three-fourths of anti-anxiety prescriptions written were for diagnosed psychiatric conditions, the remaining prescriptions were for nonpsychiatric diagnoses:
- Anxiety related to medical interventions -- 6 percent
- Allergic reactions -- 4 percent
- Back problems -- 2.5 percent
The study appears in CNS Drugs. Its data came 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, which offers sales and other data as well as consulting services to the pharmaceutical industry.