Top 25 Psychiatric Drugs in 2009

A few years back, we published the Top 20 Psychiatric Prescriptions for 2005. Four years later and we thought it’s about high time we updated that list with the help of the healthcare intelligence firm IMS Health, which tracks prescription data in the U.S. We published the new list this morning, Top 25 Psychiatric Prescriptions for 2009.

There’s a few interesting observations we can make based upon this data and the intervening four year span between the two lists.

First, anti-anxiety medications like Xanax, Valium and Ativan remain some of the most commonly prescribed psychiatric medications. And it’s no wonder — they are fast-acting and have a short half-life, meaning their effects typically wear off in a few hours. Xanax remains the most commonly prescribed psychiatric medication.

11 Comments to
Top 25 Psychiatric Drugs in 2009

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  1. Take a look off to the right here, and then think about the last antidepressant direct-to-consumer ad you saw on TV. Might it contain the words “Depression hurts. Cymbalta can help”? I’d be willing to bet the huge gain in Cymbalta prescriptions is attributable to its massive marketing campaign. They have quite a presence in certain magazines as well.

  2. These figures are great raw data, but really without context. It would be nice to know how much money was spent on direct to consumer advertising for each drug. Did the prescriptions for certain drugs reduce, or were more scripts just written for the new leaders. How much of this increase is from “mental health professionals” and how much of it is by GP’s in a 5 min office visit.

    As “anxiety medications” are on the rise. It would be enlightening to see this increase lined up against the unemployment curve since 2005. Especially for the “now cheaper” Zoloft type drugs. Like a friend of mine once said of being prescribed an SSRI. “I told the doctor I was feeling a little down because I was unemployed and about to loose my house. He gave me the prescription. A few days later I was no longer down. Sure, I was still unemployed and about to lose my house. But I didn’t care. In fact I stopped looking for work and started going out more.”

    Another curve I think would be interesting would compare these medications increase to reports of violence and suicide where these drugs were present. Of course there is no research directly connecting the two.

  3. I’m a psychiatrist, and the really sad part is, I don’t know of a single psychiatrist who would ever prescribe Xanax for anxiety. And it’s the single most prescribed psych med by far. Just goes to show how most psych meds are prescribed by primary care doctors who have very little idea what they’re doing with those meds.

    • Which you are so very correct! I have a 11yr old son who has been put on all theses meds. Since 2009 And the one which We have the most problems with is the risperdal.This medicine caused my son to develope women breast, He struggled with kids ridicules ,embarrassement, chest pain, & Depression . I’ve been seeking help to get this resolved but yet awaiting cout dates!! Parents do your own research instead of being trusting in Dr.’s opinion of what’s good or don’t have side effects that could damage your children or have them suicidal. The place my son went is for children and well know, but the damaged the Dr. Caused should be as well. Prevention of medical abuse

  4. I am surprised that klonopin didn’t make the list. I also have to wonder if these medications prescribed but for other reasons besides psychiatric use are taken into consideration. Cymblata has been FDA approved to treat fibromyalgia. Valium is used to treat muscle spasms. Many SSRIS are used to treat pain. I wonder if prescriptions for those reasons are taken into consideration when this list was made.

  5. I think that one of the reasons Valium, Xanax, and Ativan top the list is because they are commonly used as sedatives for anxious patients in hospital and other medical settings. I said I was anxiety about a procedure and I was immediately given a prescription for Ativan (didn’t fill it). Also, it’s given out in emergency rooms because it’s fast-acting. Also, some of them are potent muscle relaxers.

    I am surprised Wellbutrin isn’t higher-up. I thought it was the 4th most prescribed antidepressant? It works great, if you have my kind of depression. Also, just so everyone knows, Lexapro is almost identical to Celexa! Celexa is off-patent and much cheaper.

  6. LOL,
    There is data that shows that the suicide rate has sharply declined since the introduction of SSRIs. Not sure if they look at suicides in which “medications” are present, but in the majority of suicides, the person isn’t taking any antidepressant. (this is from testing their blood post-mortium).

  7. Oh I see. For Wellbutrin, they seperated the generic Budeprion from Wellburin XL. I guess more people are taking the generic now. That makes since.

  8. I’ve posted some more thoughts on my blog for those of you who may be interested: http://psychiatryfun.blogspot.com/

    Here’s an excerpt:
    The list is supposed to be ranked by number of prescriptions dispensed, yet for some reason, diazepam (Valium) at 14,009,000 prescriptions ranks #5 between sertraline (Zoloft) with 19,500,000 and fluoxetine (Prozac) with 19,499,000. Now I’m no math genius, but does this make sense to anybody? They do something similar with lisdexamfetamine (Vyvanse) at #18. They don’t say if the generics are lumped in with the brand name drugs, so we don’t know if 10th-ranked venlafaxine includes the brand-name Effexor XR as well as the generic instant-release venlafaxine. And why aren’t sleep meds like zolpidem (Ambien) included in the list?

  9. Thanks for pointing out the discrepancy with the two drugs’ ranking; that’s been fixed.

    Generics are included in with the brand name prescriptions, except in two cases — Wellbutrin XL and Adderall XR. [Edited for clarity]

    Wellbutrin is known by its generic name and is #14 in the list when prescribed as a generic. In its one proprietary form, Wellbutrin XL, it comes in at 22.

    These are the categorizations made by IMS Health, not us, so we’re limited by the data provided by them.

    Although sleep problems can be considered a mental health issue and are listed in the DSM, we did not ask for sleep med data.

  10. I take the generic version of Wellbutrin XL, so that would be a separate entry? I am surprised Zoloft and some brandname forms of off-patent drugs are at the top of the list. Do a lot of people will still buy the brandname after the generic becomes available? Most Insurance companies won’t even cover the brandname, except in some special circumstances, and many times the pharmacy won’t even have it.

    So people still buy a lot of brandname Xanax? This list is quite confusing. Also, it doesn’t seem to distinguish between whether a (anti-anxiety) med was prescribed for a one time occasion, such as surgery, or if the patient was given a supply of it. Also, if they included non-psychiatric purposes. Such as Adderall being used to sleep disorder or weightloss.

  11. Maybe if the doctor wrote the brandname on the prescription, they counted that as a prescription for the brandname even if the generic was eventually dispensed. I think that makes the most sense.

  12. Sorry Lynn, Wellbutrin XL is a special case, because it is still a patented formula that was made available in generic form earlier by a court order.

    Maybe we’ll just clump those two generics in with their brand name counterparts to reduce confusion. We just listed brand names primarily because most people recognize the brand names over the generic name of the drug.

  13. Isn’t it interesting how many of these drugs were either new or were part of significant advertising campaigns. A drug like pristiq for instance, or the new marketing of seroquel for depression. I take medications, but I find this chilling!

  14. Direct to consumer marketing by pharmaceutical companies is illegal in most countries. Bad enough that physicians are pressured by pharma reps and, in the US, bribed with incentives to over-prescribe, let alone by consumers without medical degrees. No wonder the numbers are so high!

  15. Question that would help me understand the data better:

    If a doctor writes a script for a month’s supply of e.g. Celexa, with 4 refills, does that count as one scrip, or five?

    It makes a difference!

  16. Valium has a half life of up to 4 days. That’s not short.

  17. Valium’s half life varies from 20 to 100 hours and obviously shouldn’t have been included in that list as an example of a short-acting anti-anxiety medication.

  18. I tried the generic buproprion xl and it gave me severe anxiety, panic, heart palpitations…. I take Wellbutrin XL without problems. How a drug is released as well as the content makes a lot of difference! I believe the generic releases faster and isn’t as extended/gradual as these are more severe versions of the side effects I get when I up my dose before winter.

  19. Do you happen to have the $ sales by product associated with the prescriptions that you published? It would be a big help to understand the relationship and also help me with a project I’m working on.

    Thanks

  20. Why is the percent change not listed for Adderall XR? The drug was tracked and presented in your list of the top 20 psychiatric prescriptions for 2005. According to the figures presented in both lists, U.S. prescriptions for Adderall XR have dropped approximately 39.3% from 2005 to 2009, yet it is neither given mention in this article nor in the updated 2009 list.

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