In a study published today in The Archives of General Psychiatry, researchers from Johns Hopkins University and the New York State Psychiatric Institute report the number of adults being prescribed psychiatric drug combinations is increasing. Between 1996 and 1997, 42% of psychiatric patients were prescribed two or more drugs. In just ten years this number has jumped to 60%. What’s more, many of the drug combinations being prescribed have never been tested before, and many are showing adverse effects like weight gain and increased cholesterol.
An interesting finding in this study is that levels of mental illness have not been increasing, but rather the increase in multiple drug treatment might be due to a psychiatric focus on symptom reduction. If you are prescribed Prozak for your depression, for example, you might develop anxiety. Your doctor might then prescribe Xanax. And so on. I’ve worked with several clients who are routinely on two or more medications. One 10-year-old boy I worked with was on five psychotropic medications at once.
What does this mean for you? Medication has become a standard and effective way to treat the symptoms of many mental illnesses. I have seen medication literally save lives. However, the science is just not there yet to support what is happening in the field. This means that you need to take it upon yourself to know what you are putting into your body, what it does, what the side-effects are, and how it interacts with other medications. Make your doctor do her homework. Have her prove to you that what she is recommending is backed by the literature and has been shown to work. There are many motivations out there for doctors to prescribe medication, unfortunately your well-being is not always at the top of the list.
One final and alarming finding in this study is that patients who are covered by Medicaid were more often prescribed multiple drugs than individuals with private insurance. This builds on an earlier study by a federally funded team from Rutgers and Columbia that found that children on Medicaid are prescribed medication for mental illness at a rate four times higher than children on private insurance. There is currently a debate as to why this discrepancy exists with reasons ranging from those on Medicaid have a harder time sticking with the regimen of therapy to Medicaid doesn’t reimburse well for therapy and thus at times the only treatment option is medication.
Chris Tickner is a Pasadena psychotherapist, child therapist, and clinical supervisor practicing holistic psychotherapy, where he combines mindfulness psychotherapy, somatic therapy, neuroscience, and good old fasion humor and compassion to form a a powerful treatment that is transformative and holistic. There are thousands of California psychotherapists, and finding a counselor or finding a therapist can be daunting. On his website, Chris provides a primer to help you find the therapist that is perfect for you! Chris is also a Pasadena therapist specializing in anxiety psychotherapy and depression psychotherapy.
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January 4, 2010 at 11:14 pm
josette
Students in my Eng 101 class researched the pros and cons of antidepressants and their increasing availability last fall. The topic was so popular and sparked so much lively debate, that I will assign the same topic this spring. I’ll add this article to the cache of research links, so that my students can read it. Interesting! I wonder what some of the other motivations are for doctors prescribing medication?
Josette
January 5, 2010 at 10:18 am
Boadie
Thank you, Chris, for a balanced and thoughtful warning to those being prescribed multiple medications.
January 5, 2010 at 5:45 pm
Joan Daidone
I have seen the right medication save lives, or improve the quality of life for friends or family members, but I have also seen the over-use and misuse of multiple drugs because psychiatrists and/or doctors don’t have the time or inclination to treat the root cause of the illness or are not able to help the patient learn behavior modification techniques or more holistic ways to deal with anxiety, depression or other mental illness. It’s also because a lot of insurance plans don’t cover therapy and the poor or uninsured don’t have access to therapy. I know it’s an issue that NAMI and other organizations are just starting to bring to the surface but there is not enough attention to it in the media. Thank you for your thoughtful article.