H.A. Pincus, T.L. Tanielian, S.C.
Marcus, M. Olfson, D.A. Zarin, J. Thompson, J.M. Zito, Prescribing trends in psychotropic
medications, JAMA, 18 February 1998, 279 (7), 526-531
Article reviews changes between 1985 and 1993-1994 in prescribing
patterns of SSRIs and other psychotropic medications - this whole class representing 8.8%
of the US prescription drug market in 1994. Over this nine year time span, "all
psychotropic drug visits" to doctors increased from about 33m to 46m; as a proportion
of all visits, an increase from 5.1% to 6.5%.
Visits for depression increased from 10.99m in 1988 to 20.43m in 1993 and 1994. For
reasons discussed but unclear, the proportion of visits for depression when a drug was
prescribed increased for psychiatrists but not for primary care physicians.
This article contains useful data on consumption of antidepressants. Authors conclude
"it is premature to draw any conclusions about appropriateness or quality of
care". Paper seems thin on discussion. Authors appear not to question the widely held
view that more SSRI prescribing = better mental health.
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