One in Five American Adults Takes Psychiatric Drugs

The medicating of Americans for mental illnesses continued to grow over the past decade, with one in five adults now taking at least one psychiatric drug such as antidepressants, antipsychotics and anti-anxiety medications, according to an analysis of pharmacy claims data released Wednesday.

Among the most striking findings was a big increase in the use of powerful antipsychotic drugs across all ages, as well as growth in adult use of drugs for attention-deficit hyperactivity disorder (ADHD) a condition typically diagnosed in childhood. Use of ADHD drugs such as Concerta and Vyvanse tripled among those aged 20 to 44 between 2001 and 2010, and it doubled over that time among women in the 45-to-65 group, according to the report.

Overall use of psychiatric medications among adults grew 22 percent from 2001 to 2010. The new figures are based on prescription drug pharmacy claims of two million US insured adults and children reported by Medco Health Solutions Inc., a pharmacy benefit manager based in Franklin Lakes, N.J.

While the use of most psychiatric drugs grew strongly, there were declines in antidepressant use in children and anti-anxiety drug use in the elderly, likely in part because of concern over potential side effects.

The patterns are consistent with, but more pronounced than, published findings from national government data, which tend to have a lag time. A recent Archives of General Psychiatry paper looking at data before 2005 found that about 10 percent of the population took an antidepressant. Wednesday's data found that about 10 percent of adult men used antidepressants in 2010, but 21 percent in adult women did.

Psychiatric medications are among the most widely prescribed and biggest-selling class of drugs in the US. In 2010, Americans spent $16.1 billion on antipsychotics to treat depression, bipolar disorder and schizophrenia, $11.6 billion on antidepressants and $7.2 billion on treatment for ADHD, according to IMS Health, which tracks prescription drug sales.

Whether psychiatric drugs are used appropriately or not has been a longstanding concern among medical professionals and policy makers in the US. Evidence continues to grow about possible serious side effects, particularly among children and the elderly. For instance, in 2004 the Food and Drug Administration required a "black box" warning, its most serious, about the possible increase in suicidal thoughts in children and teens taking antidepressants, and in 2005 it warned about the increased risk of death with certain antipsychotics in elderly patients with dementia.
Wednesday's report offered some evidence that such warnings have impact: Antidepressant use in children peaked in 2004 and dropped last year to 2001 levels, around 2.5 percent for girls and just over two percent for boys.

Still, there was a pronounced increase in medications to treat ADHD among young and middle-aged adults, particularly in women. Use in the over-65 population also increased about 30 percent for men and women between 2001 and 2010.

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