It seems that new studies come out weekly singing the praises of this drug or that therapy to treat a slough of mental and physical health problems. One of the biggest problems with this scenario is that, in many cases, we don’t know nearly enough about what will happen when a patient receives a certain treatment. This is especially true with prescription drugs, which are doled out for everything from high blood pressure to low mood—often without sufficient evidence that the treatment will be helpful. This is not a pro-therapy, anti-medication rant: it’s a response to a major cross-national study of antipsychotic prescription trends over the past 13 years.
Antipsychotic prescriptions jumped from 6.2 million in 1995 to 16.7 million in 2008. Of those, more than half (4.4 million in 1995, 9 million in 2008) were prescribed for “off-label” uses: conditions that may benefit from the drug, but haven’t been officially approved as such by the FDA due to insufficient evidence and testing. This isn’t illegal, and in some cases it’s helpful, but it’s unlikely that the majority of patients prescribed antipsychotics fall into this category. What’s more, off-label antipsychotic prescriptions accounted for an estimated $6 billion in spending during 2008 alone.
It’s not just the price tag that’s a concern, but the fact that many of these antipsychotic drugs come with quite serious side effects. They should be prescribed carefully, with great consideration by both the psychiatrist and the patient. Yet doctors often oversell benefits and undersell risks when it comes to prescription medications (mental health and physical health both included). Dr. John M. Grohol sees several factors contributing to this trend, not the least of which is the “pro-treatment” attitude that inspires doctors, therapists, counselors, and psychiatrists to enter their respective fields in the first place. “Their default bias is to treat, not to not treat,” he writes. In many cases, there may not be a treatment that will solve a problem outright, even with appropriate prescriptions and therapy combined. But this doesn’t mean the patient’s life can’t be improved, their coping skills strengthened. Heavy marketing from pharmaceutical companies makes some patients think that trying a dangerous drug is worth it, even if there’s little evidence to back that up. While it may feel better to do something rather than nothing, the dangerous side effects of antipsychotics are a big risk to take if the only likely benefit is the same as a placebo.
© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
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