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The findings highlight the need for more research into the effects of long-term use of the most commonly prescribed psychiatric medications.
Thomas Moore, A.B., of the Institute for Safe Medication Practices in Alexandria, Va., and Donald Mattison, M.D., of Risk Sciences International in Ottawa, Canada, used the 2013 Medical Expenditure Panel Survey to calculate the percentages of adults using antidepressants; anxiolytics, sedatives, and hypnotics; and antipsychotics. Long-term use was defined as a patient having filled three or more prescriptions in 2013 or reporting that they had started taking the drug in 2011 or earlier.
Overall, 16.7% of 242 million U.S. adults reported filling one or more prescriptions for psychiatric drugs, including 12.0% taking antidepressants; 8.3% taking anxiolytics, sedatives, and hypnotics; and 1.6% taking antipsychotics. A total of 84.3% of the psychiatric drug use reported was long term.
The authors noted that antidepressant prescribing information includes limited information about appropriate duration of treatment, while many hypnotics such as benzodiazepines have warnings related to long-term risks.
“Safe use of psychiatric drugs could be improved by increasing emphasis on prescribing these agents at the lowest effective dose and systematically reassessing the need for continued use,” the authors wrote.
The study also revealed that overall psychiatric drug use was higher in women compared with men (21.2% versus 11.9%); whites (20.8%) compared with Hispanics, blacks, and Asians (8.7%, 9.7%, and 4.8%, respectively); and older adults (25.1% among adults 60 to 85, 18.8% among adults 40 to 59, and 9.0% of adults 18 to 39).
For related information, see the Psychiatric News article “Long-Term Use of Benzodiazepines: Issues and Challenges,” by George Dawson, M.D., and the Psychiatric Services article “A Prescription for ‘Deprescribing’ in Psychiatry.
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