About one in six adults in the Netherlands takes a psychoactive medicine. Usually these are antidepressants, tranquilizers or antipsychotics. So says a new study published in the journal JAMA Internal Medicine.
Different classes of psychoactive drugs have been studied including antidepressants, sedatives and hypnotics for the treatment of insomnia and antipsychotics usually prescribed to patients who have mania from bipolar disorder or psychosis due to schizophrenia.
The top 10 psychiatric drugs reported in the new study were sertraline hydrochloride (Zoloft, an antidepressant); citalopram hydrobromide (Celexa, an antidepressant); alprazolam (Xanax, an anti-anxiety drug); zolpidem tartrate (Ambien, a hypnotic medicine); fluoxetine hydrochloride (Prozac, an antidepressant); trazodone hydrochloride (Desyrel, an antidepressant); clonazepam (Klonopin, an anti-anxiety drug); lorazepam (Ativan, an anti-anxiety drug); escitalopram oxalate (Lexapro, an antidepressant); and duloxetine hydrochloride (Cymbalta, an antidepressant).
Especially the elderly and women
In the past, it was mainly middle-aged adults who used these drugs the most, while they are now elderly. The use of drugs thus appears to increase with age. This is a surprising finding because elderly people, in particular, may be at risk of falling and developing cognitive impairment from taking these drugs.
Moreover, women more often indicated that they used these drugs. Men may generally be more dismissive of the symptoms and are less likely to seek treatment for their psychological problems.
In addition, the majority of people surveyed report using them for a long time. There is a legitimate risk of withdrawal symptoms when these medications are stopped abruptly. Therefore, both patients and physicians should regularly reassess the ongoing need for these agents. It is important for patients to understand that after stopping treatment with psychoactive drugs the problem may return. However, withdrawal symptoms can also occur if it is stopped abruptly. This can be avoided if doctors gently help patients reduce their dose.
Causes and consequences
The possible cause may lie with the prescribers themselves. Because psychiatrists are an underrepresented specialty in health care in the Netherlands, primary care physicians are increasingly prescribing medicines to treat psychological problems. As a result, certain medications may be prescribed more often than others, depending on which one the prescribing physician is most comfortable with. For example, it may well be possible that there are patients with untreated mood disorders Order Zolpidem to relieve their insomnia when they would probably benefit more from antidepressants. More than once we see that doctors prefer to treat the symptoms rather than the underlying condition.