Fifty-nine percent of all prescriptions filled for psychotropic medications are written by general practitioners, according to a research report published this month in Psychiatric Services.
The study, conducted by researchers from Thomson Reuters and the federal Substance Abuse and Mental Health Services Administration (SAMHSA), analyzed prescribing patterns for psychotropic drugs from August 2006 through July 2007.
Of the 472 million prescriptions written for psychotropic medications during the study period, the researchers found that general practitioners prescribed 62 percent of antidepressants, 52 percent of stimulants (mainly drugs to treat attention deficit hyperactivity disorder), 37 percent of antipsychotics, and 22 percent of anti-mania medications. Pediatricians were included as general practitioners and wrote 25 percent of all stimulant prescriptions.
"The important role of general practitioners in prescribing antidepressant medications and treating depression has been documented," the study authors wrote. "However, the extent to which general practitioners are prescribing other types of psychotropic medications has received less emphasis."
Prescribing of psychotropic medications by non-psychiatrists may improve access to treatment for many patients, the study notes. However, the authors cite concerns about whether patients treated by non-specialists receive psychotherapy, medication monitoring, appropriate intensity of treatment, and treatment consistent with evidence-based guidelines. Moreover, they cite recent evidence that primary care physicians often are unable to find outpatient mental health services for their patients.
Primary care plays a large role in psychotropic drug prescribing and will likely continue to do so. The researchers stress that it is important to ensure the quality of psychiatric treatment in general practice settings across a range of psychiatric conditions.
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