The Staggering Numbers Behind Overprescribed Antipsychotics

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

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • TK


    January 14th, 2011 at 2:14 PM

    We are a slave to meds.The medical fraternity is a slave to meds.Unless there is a radical change coming along,we will continue to see scores of people actually having problems DUE to meds.

  • nancy


    January 14th, 2011 at 3:30 PM

    It does not take a rocket scientist to see that there are way too many meds being over prescribed these days. There is way too much money to be made off of big pharma and they will do anything in their power to ensure that this will not change. That in a nutshell is a great deal with what is wrong with our healthcare system today. Poeople are way too concerned with how much money they will be making and losing instead of focusing on the reality of the patients’ needs.

  • Jenn


    January 15th, 2011 at 7:03 AM

    The one thing that we have to remember is that some docs are only bowing to the wishes of the patients. Patients today think that a prescription is going to be an easy fix, no matter whether it is about mental health, weight loss, or whatever. So they are crumbling under the pressure of their patients to give them the medicines. Vicious cycle. We have bought into the idea that a medicine can be the quick fix and we have done a successful job at convincing our doctors that this is the only solution that we will tolerate and accept.

  • Lynne


    January 16th, 2011 at 2:05 PM

    It’s like ADHD medicine: it does work when given to the right people, but for everyone else it just makes them drugged and miserable. Not a good way to live. Antipsychotics are a good way to keep yourself in check when you need them, but it’s just a sock around a leaky pipe. You need to fix the pipe and get rid of the problem. They’re there to support you through hard times, not hold your hand and carry you.

  • lorraine


    January 16th, 2011 at 3:21 PM

    I am stunned that off-label uses of antipsychotics isn’t against the law! That needs to be remedied and fast. Official FDA approval is the only guarantee we patients have of safe use, and even then it’s not infallible.

  • Karen


    January 16th, 2011 at 6:11 PM

    Even if off-label use is not against the law, the whole concept feels unethical to me. Why would a doctor do that instead of using what’s already available to them AND approved for whatever condition they are attempting to treat? They are taking a risk that needn’t be taken.

  • Rachel


    January 17th, 2011 at 4:43 PM

    This is another good reason to go down the path of therapy first and medication second. We need to quit accepting this idea that pills are the answer to every ill quite so readily because they simply are not. The sooner people get that through their heads, the better for all of us.

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Title   Content   Author is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding any mental health symptom or medical condition. Never disregard professional psychological or medical advice nor delay in seeking professional advice or treatment because of something you have read on