by Dee Rapposelli
Prescriptions for psychotropic drugs for adolescents aged 14 to 18 years increased by 250% between 1994 and 2001. The bulk of the momentum occurred from 1999 onward, according to a study by a team from Brandeis University in Waltham, Mass. The team, led by Cindy Parks Thomas, PhD, senior scientist at the Scheider Institute for Health Policy at Brandeis and an expert on prescription drug trends, suggested that the sharp increase was a result of changes in federal laws (FDA Modernization Act) enacted in 1997 that allowed direct-to-consumer (DTC) promotion of psychotropic drugs and relaxed regulations about promotion of off-label use of prescription medications.
Analyzing data from the National Ambulatory Medical Care Survey, the researchers found that prescriptions for psychotropic drugs written for persons aged 14 to 18 increased at a rate of 8.3% between 2000 and 2001, compared with a 3.4% increase between 1994 and 1995. By 2001, 1 out of every 10 office visits by adolescent males resulted in a prescription for a psychotropic medication, the researchers wrote in the January issue of Psychiatric Services (Parks Thomas CP et al. Psychiatr Serv. 2006;57:63-69).
Attention deficit hyperactivity disorder was the diagnosis in about a third of office visits during the period studied. No mental health–associated diagnosis was made in 14% to 26% of office visits that resulted in psychotropic drug prescription.
The researchers noted that the trend coincided with a 6-fold increase in spending (to $1.5 billion) by pharmaceutical companies for DTC television advertising between 1996 and 2000. It was an increase that primarily took flight in 1997, presumably on the wings of the FDA Modernization Act. Thomas conceded that reasons for [the] trend need further scrutiny and—apart from marketing issues—may include greater acceptance of psychotropic therapies among physicians and greater vigilance in mental health screening.