Ha. Pincus et al., PRESCRIBING TRENDS IN PSYCHOTROPIC MEDICATIONS - PRIMARY-CARE, PSYCHIATRY, AND OTHER MEDICAL SPECIALTIES, JAMA, the journal of the American Medical Association, 279(7), 1998, pp. 526-531
Context.-Psychotropic medications are widely prescribed, but how new c
lasses oi psychotropic medications have affected prescribing patterns
has not been well documented. Objective.-To examine changes between 19
85 and 1994 (data from 1993 and 1994 were combined) in the prescribing
patterns of psychotropic: medications by office-based primary care ph
ysicians, psychiatrists, and other medical specialists. Design.-Nation
al estimates for the number of visits during which a physician prescri
bed a psychotropic medication based on the National Ambulatory Medical
Care Surveys conducted in 1985, 1993, and 1994. Setting.-Office-based
physician practices in tile United Stales. Participants.-A systematic
ally sampled group of office-based physicians. Main Outcome Measures.-
National estimates of visits that included a psychotropic medication.
Results.-The number of visits during which a psychotropic medication w
as prescribed increased from 32.73 million to 45.64 million; the propo
rtion of such visits, as a proportion of all visits, increased from 5.
1% to 6.5% (P less than or equal to.01). Antianxiety or hypnotic drug
visits, previously the largest category, decreased as a proportion of
psychotropic drug visits (P less than or equal to.01) and are now surp
assed by antidepressant visits, Visits for depression increased from 1
0.99 million in 1988 to 20.43 million in 1993 and 1994 (P less than or
equal to.01). Stimulant drug visits increased from 0.57 million to 2.
86 million (P less than or equal to.01). Although visits for depressio
n doubled for both primary care physicians and psychiatrists, the prop
ortion of visits for depression during which an antidepressant was pre
scribed increased for psychiatrists but not for primary care physician
s. Conclusions.-The patterns of psychotropic medication use in outpati
ent medical practice changed dramatically during the study period, esp
ecially in psychiatric practice.