America's State of Mind: New Report Finds Americans Increasingly Turn to Medications to Ease their Mental Woes; Women Lead the Trend

More than One-in-four Women take Medication to Treat a Mental Health Condition

Women's Use of ADHD Drugs Surged 2.5 Times over Decade, Surpasses Men's Usage

Nov 16, 2011, 00:01 ET from Medco Health Solutions, Inc.

FRANKLIN LAKES, N.J., Nov. 16, 2011 /PRNewswire/ -- What could be a sign of America's psychological state of mind, a new report shows more than one-in-five adult Americans took at least one medication commonly used to treat a psychiatric or behavioral disorder in 2010.  Women's use was even higher, with one-in-four on a mental health-related drug last year.  That's according to "America's State of Mind," a Medco Health Solutions, Inc. (NYSE: MHS) analysis of trends in mental health medication usage among approximately 2.5  million insured Americans, comparing utilization of antidepressants, antipsychotics, attention deficit hyperactivity disorder (ADHD) drugs and anti-anxiety treatments from 2001 to 2010.  

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The report finds that women of all ages take more mental health medications than their male counterparts.  Antidepressants are by far the most commonly utilized, with over 20 percent of women on a drug typically prescribed to treat depression.  Anxiety treatments are also widely used by women and at almost twice the rate of men; the greatest use is found among middle-aged women (45-65 years old), 11 percent of whom were on an anti-anxiety drug last year.  

While many more boys than girls are prescribed treatments for ADHD, once they grow up that picture changes dramatically.  Overall, the number of women on ADHD drugs was 2.5 times higher than in 2001- overtaking men in their use of these drugs.  The most striking jump was seen in 20-44 year old women whose numbers rose 264 percent in ten years.

"Over the past decade, there has been a significant uptick in the use of medications to treat  a variety of mental health problems; what is not as clear is if more people - especially women, are actually developing psychological disorders that require treatment, or if they are more willing to seek out help and clinicians are better at diagnosing these conditions than they once were," said Dr. David Muzina, a psychiatrist and national practice leader of the Medco Neuroscience Therapeutic Resource Center®.  "Women are generally more frequent users of healthcare, but they may also be bearing the emotional brunt of a decade that started with the horror of 9/11 and since has seen several wars and economic turmoil."

While women are the predominant users of atypical antipsychotics, there has been a huge upswing in utilization of these drugs among males as well, quadrupling in men ages 20-64 since 2001.

"The overall results, that substantially more individuals are on psychotropic medications is sobering and important.  Understanding the reasons for this increase is the next critical goal," said Dr. Martha Sajatovic, Professor of Psychiatry at Case Western Reserve University School of Medicine and Director of the Neurological Outcomes Center, University Hospitals Case Medical Center.  "The health care implications could be substantial given increasing financial constraints on individuals and health care funding entities."

Children's Use of Antipsychotics Spikes, Antidepressant Use Falls

The number of children (19 and younger) on mental health drug treatments was up in all areas over the past ten years, with antidepressants being the one exception – dropping substantially since the Food and Drug Administration (FDA) issued warnings in 2004 on risks of suicidal ideation linked to these drugs in children. Use of ADHD drug use has also been on the decline in both boys and girls since 2005.  Boys are the primary users of ADHD drugs and atypical antipsychotics, while a greater number of girls take antidepressants and anti-anxiety drugs.    

While the actual prevalence of children on atypical antipsychotics is low (under one percent), the number doubled from 2001 to 2010.

"The fact that more children are being treated with atypicals is concerning given that substantial weight gain is highly associated with the use of these drugs in this population, putting children at risk for diabetes and heart disease-related conditions," said Dr. Muzina.  "When using these drugs, children need to be monitored on a frequent basis to prevent against these serious health risks."  

Surging Rx Use in Younger Adults

Among adults, those ages 20-44 showed the greatest spikes in the use of mental health drugs over the decade for three of the four medication categories.    

In addition to more than tripling their use of ADHD medications since 2001, the 20-44 age group also saw significant spikes in utilization of atypical antipsychotics (248 percent) and their use of anti-anxiety treatments was up nearly 30 percent. From the start of the decade, the number of men in this demographic on a mental health medication grew at a faster clip than their female counterparts - up 43 percent versus 25 percent.

Elderly Show Mixed Pattern of Use

Older women are most apt to use an antidepressant, with nearly 24 percent of those over 64 taking these medications.  They also had the greatest jump in use of antidepressants since 2001, posting a 40 percent increase their numbers. Their use of atypical antipsychotics has been on the rise since as well, up 88 percent since the start of the decade. However, there was a steep decline in the number of elderly women taking anti-anxiety medications, down 47 percent from a decade ago.

Diabetes Belt Shows Heavy Use of Mental Health Drugs

The analysis reviewed regional use of mental health medications in 2010 and found the highest numbers of patients on mental health medications (23 percent) in the east south central region of the U.S., part of the "diabetes belt" that includes Tennessee, Kentucky, Mississippi and Alabama. The area where the fewest people are prescribed mental health treatments (15 percent) is in the east north central region which includes Indiana, Ohio, Wisconsin and Michigan.

"Studies have shown that people with diabetes do have higher levels of depression and anxiety disorders so it's not surprising that we see great use of mental health-related medications in the 'diabetes belt' region, said Dr. Muzina.  "It's not clear however, what the relationship is which is why it's especially important that patients with diabetes be monitored for symptoms of depression and anxiety and vice versa.  Having a coordinated care team is extremely important for these patients."  

Patients suffering from behavioral health disorders along with other related conditions benefit from the expertise of Medco's specialist pharmacists who have advanced training and expertise in these and other health conditions including diabetes, cardiovascular disease, pulmonary conditions and cancer.  Diabetes specialist pharmacists assist in the care of patients with depression and diabetes to ensure they receive the proper diabetes treatment.  Specialist pharmacist are also better equipped to identify and address medication adherence problems which is especially important for those with mental health conditions since research shows these patients are more prone to poor adherence with medications used to treat comorbidities such as diabetes, asthma and heart disease and, in general, have poorer health outcomes.          

About America's State of Mind Analysis

America's State of Mind analysis was based on a random sample of a cohort from Medco's de-identified database of those with 24 months of continuous prescription drug insurance enrollment and eligibility (12 months in the year of interest and 12 months in the prior year).  Sampling was stratified by age, sex and region to match the demographics of the larger cohort.  The probability sample reflects the prevalence of prescription drug use in a commercially insured, primarily private sector population with stable coverage and employment.

To access the America's State of Mind report, please visit

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