Antidepressants, Anxiolytics Most Likely to Be Prescribed Without Diagnosis

More than half of individuals who are prescribed psychotropic medications do not have a documented psychiatric disorder, according to a study published in the September Psychiatric Services. Researchers analyzed over five million MarketScan claims from 2009 and found that 58% of individuals who were prescribed a psychotropic medication did not have any psychiatric diagnosis.

Patients were categorized into three age brackets: 18-39 years, 40-49 years, and 50-64 years. The results showed that patients in the oldest age bracket (25%) were more likely to be prescribed psychotropic medications than patients in the youngest age bracket (16%).

Of the medications, antidepressants and anxiolytics were the most likely to be prescribed to patients without a psychiatric diagnosis (62% and 46% respectively), while the least likely to be prescribed without a psychiatric diagnosis were lithium, stimulants, and antipsychotics.  “It is unclear why these classes of medications were so closely linked to diagnosis,” said the researchers. “One possibility is that these medications have more narrowly defined clinical indications for use and lower rates of off-label prescribing than the other classes studied.”

An overwhelming majority of psychotropic prescriptions prescribed without a psychiatric diagnosis was to patients who did not use any mental health specialty care services, leading researchers to believe that most of these medications were being prescribed in primary care, general medical, and surgical settings.

For the full report, see "Prescribing of Psychotropic Medications to Patients Without a Psychiatric Diagnosis."

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