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Senior Use of Psychiatric Drugs Spikes
By Marilyn Elias , USA today
May
5, 2009
An increase in use of mental health drugs in those over 65 was driven mostly by SSRIs (a newer class of antidepressants), such as Prozac.
About 15% of elderly Americans had prescriptions for psychiatric drugs in 2006, double the percentage a decade earlier, according to an analysis of federal databases out today.
A rising number of people of all ages received treatment for mental disorders over the 10 years, but there's evidence that the most seriously ill may be receiving less care from specialists, says the study by health policy researchers Sherry Glied of Columbia University and Richard Frank of Harvard Medical School. The report in Health Affairs covers trends in the well-being of those with mental health problems.
The biggest change came for those 65 and older: About 16% were diagnosed with a mental illness, roughly double the percentage in 1996, with 15% overall given psychiatric prescriptions. This surge in medication use was driven mostly by popularity of the newer class of antidepressant drugs — SSRIs such as Prozac — and atypical antipsychotic drugs, Frank says. Antipsychotics carry the most serious safety warnings, ordered by the Food and Drug Administration, because they increase death rates in older people with dementia. But the medicines are still widely prescribed to control agitation and aggressive behavior in elderly patients who have dementia.
The increase in treatment for children and adults under age 65 has come about through increased diagnosis by primary care doctors, the report says. But the increased treatment seems to be providing the most help to those with less serious problems. Adults who say their activities are limited by mental illness were less likely to have contact with a mental health professional in 2006 than 1996, and the decrease was greatest for the elderly, dropping from 30% to 20%.
Seniors are most concerning to us," Frank says. Traditionally, they've been the most under-treated. Now many are getting psychiatric medication, but, among the seriously impaired, access to specialists is dropping.
Some positive steps, such as the 2008 federal parity law requiring employers to provide comparable insurance coverage for physical and mental illness, could improve access to care, Frank says. But the recession — beginning a year after the study period ended — will reverse some progress in mental health care, he adds, because so many people have lost their jobs and insurance coverage.
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