We Americans love our pills. A record 4.02 billion drug prescriptions were written last year in the U.S., up from 3.99 billion in 2010. The reasons we’re taking all these treatments are as complex and varied as the medications themselves.
Top prescription drugs were the subject of a short but interesting study published recently in the journal ACS Chemical Neuroscience that had a special focus on medications for central nervous system disorders. The study broke down all medications into pharmaceutical products, classes of drugs and also logged how much we’re spending on all of this.
Among the more interesting tidbits, antidepressants such as Zoloft and Celexa were the most prescribed class of drugs in 2011, with a whopping 264 million prescriptions filled. The cholesterol-lowering statin Lipitor was the number-one selling brand-name drug, racking up $7.7 billion in sales in 2011, up from $7.3 billion in 2010.
Antipsychotic drugs, used to treat conditions such as bipolar and obsessive-compulsive disorders, were the fifth-ranked most prescribed drug by sales. And prescriptions for attention-deficit hyperactivity disorder drugs jumped 17 percent from 2010 to 2011.
It may be easy to blame the increases solely on a society that’s big on trying to cure everything from obesity to migraines by popping a pill, but that’s only one element that may explain these numbers.
Antidepressants, for example, aren’t only used to treat depression, but also a smorgasbord of other disorders, such as anxiety, chronic pain, and even menstrual and menopause symptoms.
“The conditions they’re used for treating are the most widely diagnosed things,” Dr. Andrew Leuchter, professor of psychiatry and biobehavioral sciences at the Semel Institute for Neuroscience and Human Behavior at UCLA, told TakePart. “If you look at anxiety disorders alone, they’re one of the most common medical disorders in the country.”
In fact, he says, studies suggest that sometimes these drugs may not be prescribed enough, since people’s symptoms aren’t always accurately diagnosed and treated. “Even if they were treated,” he adds, “what you frequently find is that doses are too low or not given long enough.”
Another part of the puzzle that can’t be ignored is the millions of dollars spent on relentless advertising of brand-name prescription drugs. With ads that make it seem like the solution to crippling depression or plaque-free arteries is just a pill away, why wouldn’t you ask your doctor for them?
And if there’s any doubt that people are paying attention to commercials showing men and women running slow-mo through a meadow, ask any physician how many patients have requested or been curious about specific medications.
“That’s a whole can of worms,” says Dr. Caleb Alexander, a research scientist at the Johns Hopkins School of Public Health, about the ads. “Whether it’s good or bad, one of the arguments for this type of advertising is that it can de-stigmatize mental illness and prompt people to go to their physicians and ask about their condition.”
Overall, medications have gotten better over the years, too, Leuchter says, both in terms of effectiveness and side effects. That’s made them more attractive to both physicians and patients.
“I think the main driver of the use of these medications is that they work,” he adds. “There’s clearly a major benefit from statins, and the new generation of antipsychotics have much better side effect profiles than their predecessors.”
But are there instances when pills are prescribed and reached for too easily for conditions that may be better treated with non-medical interventions such as psychotherapy, exercise or meditation?
“I think for many people there is an inclination to believe there is a pill for every ill,” Alexander says. Even that tendency has its complexities. “But other treatments may be harder to access, may take more time and effort and may not be covered by insurance. Take obesity as an example. Would you rather have to start eating fruits and vegetables or take a statin every night?”
Do you think there should be limits on prescription drug advertising? Let us know in the comments.