Psychiatric medications are an important part of treatment for many people with mental disorders, such as depression, bipolar disorder, ADHD, schizophrenia, anxiety, and others. They play an important role in helping to alleviate the most serious symptoms, allowing people to better focus on their lives and on other treatment types, such as psychotherapy. Psychiatric medications are an important part of many people’s treatment plans for obtaining the most effective treatment for a mental health concern or mental illness.

It’s good to know what drugs are being prescribed most often for mental disorders in the U.S. These are the top 25 psychiatric medications by number of U.S. prescriptions dispensed in 2018, according to IQVIA, a global information and technology services company.

Maintaining its lead since we last did this review in 2016, Zoloft — a common, older selective serotonin reuptake inhibitor (SSRI) prescribed to help alleviate the symptoms of depression — remains the most prescribed psychiatric medication in the United States. Zoloft was prescribed nearly 49 million times in 2018, at a cost of $179 million. This makes it an affordable and easy-to-tolerate antidepressant choice.

It continues to be outprescribed over other antidepressants, as well as Xanax, a commonly-prescribed anti-anxiety medication found in our number two spot. Lexapro — another antidepressant used to treat clinical depression — holds on to its number three spot, with nearly 38 million prescriptions in 2018.

By far, the most common mental disorder that psychiatric medications are prescribed for is clinical depression. Although it is not the most prevalent mental disorder, it appears to the one that most psychiatric prescriptions are written for.

In 2016, more than 338 million prescriptions were written for anti-depressant medications. In 2018 that number decreased to 318 million — suggesting a slight decline in prescriptions for antidepressants.

A total of 611,780,251 prescriptions were made for psychiatric medications in the U.S. in 2018, at a cost of over $29 billion. That’s up only 2.42% from 2016, when 597,326,489 psychiatric prescriptions were made.

The most expensive medications on the list that make the most money for their manufacturers are:

  • Vyvanse (for ADHD) – $3.594 billion
  • Concerta (for ADHD) – $2.176 billion
  • Adderall (for ADHD) – $1.914 billion
  • Abilify (for bipolar disorder, depression and schizophrenia) – $1.704 billion
  • Wellbutrin (for depression) – $1.024 billion

It’s no wonder that so many people believe we are over-medicating kids and teenagers who might suffer from attention deficit hyperactivity disorder (ADHD) — they make up three of the top five profitable medications in this list. In short, ADHD make up the cost of over a third of the prescriptions in 2018. Only antipsychotic medications — prescribed for various disorders including schizophrenia and bipolar disorder — cost more as a category.

    1. Zoloft (sertaline) – Depression (48,999,022 prescriptions – $179 million)
    2. Xanax (alprazolam) – Anxiety (39,916,469 prescriptions – $105 million)
    3. Lexapro (escitalopram) – Depression (37,927,061 prescriptions – $174 million)
    4. Desyrel (trazodone) – Anxiety, Depression (34,665,828 prescriptions – $115 million)
    5. Wellbutrin (bupropion) – Depression (34,472,232 prescriptions – $1.024 billion)
    6. Adderall (dextroamphetamine and amphetamine) – ADHD (33,807,381 prescriptions – $1.914 billion)
    7. Prozac (fluoxetine) – Depression (31,190,127 prescriptions – $294 million)
    8. Celexa (citalopram) – Depression (28,011,615 prescriptions – $46 million)
    9. Cymbalta (duloxetine) – Depression (26,032,770 prescriptions – $378 million)
    10. Ativan (lorazepam) – Anxiety (23,833,390 prescriptions – $137 million)
    11. Effexor (venlafaxine) – Depression (21,717,245 prescriptions – $414 million)
    12. Seroquel (quetiapine) – Bipolar disorder, Depression (20,844,624 prescriptions – $273 million)
    13. Lamictal (lamotrigine) – Bipolar disorder (15,434,708 prescriptions – $731 million)
    14. Concerta (methylphenidate) – ADHD (15,104,867 prescriptions – $2.176 billion)
    15. Kapvay (clonidine) – ADHD (15,058,561 prescriptions – $171 million)
    16. Remeron (mirtazapine) – Depression (13,539,039 prescriptions – $89 million)
    17. Paxil (paroxetine) – Depression (12,874,006 prescriptions – $123 million)
    18. Elavil (amitriptyline) – Depression (12,843,459 prescriptions – $96 million)
    19. Vyvanse (lisdexamfetamine) – ADHD (11,569,232 prescriptions – $3.594 billion)
    20. Depakote (divalproex) – Bipolar disorder (11,263,321 prescriptions – $363 million)
    21. Abilify (aripiprazole) – Bipolar disorder, Depression, Schizophrenia (10,680,324 prescriptions – $1.704 billion)
    22. Risperdal (risperidone) – Bipolar disorder, Schizophrenia (10,416,641 prescriptions – $485 million)
    23. Zyprexa (olanzapine) – Bipolar disorder, Schizophrenia (7,192,047 prescriptions – $126 million)
    24. Intuiv (guanfacine) – ADHD (5,696,366 prescriptions – $70 million)
    25. Trileptal (oxcarbazepine) – Bipolar disorder (4,548,937 prescriptions – $322 million)

Psychiatric medications should only be prescribed by your treating psychiatrist or physician. The most effective treatment for most mental disorders is rarely medication alone. A combined treatment approach, that includes psychotherapy, results in quicker, more positive outcomes for most people who are coping with mental illness.

I know that many people take a medication alone. Or they take a medication prescribed by their family doctor, having never seen a mental health professional such as a psychologist or psychiatrist. If you’ve had a long-term disorder you’re living with, this may be just fine.

But if you’re a newly diagnosed individual with a mental disorder, you really should reach out to a psychiatrist or psychologist to confirm your diagnosis, and consider additional treatment options. There are a wealth of self-care strategies that a therapist can help you with as well. Many people find online support groups helpful, too. The important thing is to receive the best possible and most comprehensive treatment you can.

We last wrote about the the top psychiatric prescription drugs in 2016, and previously in 2013.

We would like to thank the good folks at IQVIA for providing the data.