Inappropriate Prescribing: Americans Are Taking Medications That May Not Work or May be Inappropriate for Their Mental Health Problems

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Writing a prescription to treat a mental health disorder is easy, but it may not always be the safest or most effective route for patients, according to some recent studies and a growing chorus of voices concerned about the rapid rise in the prescription of psychotropic drugs.

Today, patients often receive psychotropic medications without being evaluated by a mental health professional, according to a study last year by the Centers for Disease Control and Prevention (CDC). Many Americans visit their primary-care physicians and may walk away with a prescription for an antidepressant or other drugs without being aware of other evidence-based treatments — such as cognitive behavioral therapy — that might work better for them without the risk of side effects.

“I would say at least half the folks who are being treated with antidepressants aren’t benefiting from the active pharmacological effects of the drugs themselves but from a placebo effect,” says Steven Hollon, PhD, a psychology professor at Vanderbilt University who has conducted extensive research on the effectiveness of antidepressants. “If people knew more, I think they would be a little less likely to go down the medication path than the psychosocial treatment path.”

The use of psychotropic drugs by adult Americans increased 22 percent from 2001 to 2010, with one in five adults now taking at least one psychotropic medication, according to industry data. In 2010, Americans spent more than $16 billion on antipsychotics, $11 billion on antidepressants and $7 billion for drugs to treat attention-deficit hyperactivity disorder (ADHD). The rapid growth of all three classes of drugs has alarmed some mental health professionals, who are concerned about the use of powerful antipsychotic drugs by elderly nursing home residents and the prescription of stimulants to children who may have been misdiagnosed with ADHD.

Psychotropic drugs are valuable tools in treating many mental health disorders, but inappropriate prescribing can cause serious harm. To help address those concerns, APA is developing clinical treatment guidelines that will help educate physicians, health insurers and the public about the best treatments available for common mental health disorders. APA also supports an integrated approach to health-care delivery in which primary-care and mental health providers work together to determine the best treatment plan for each patient.

By Brendan L. Smith, American Psychological Association

http://www.apa.org/monitor/2012/06/prescribing.aspx

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