PRESCRIBING TRENDS IN PSYCHOTROPIC MEDICATIONS - PRIMARY-CARE, PSYCHIATRY, AND OTHER MEDICAL SPECIALTIES

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.