Why Are Antipsychotics the Top-Selling Drug in America?
Antipsychotics are the most commonly prescribed class of medications in the United States
, with prescription sales of $14.6 billion in 2009.
The second-generation or "atypical" antipsychotics have fewer and less serious side effects than the original or "typical" antipsychotics, and are generally considered the first line treatment for schizophrenia, psychosis, mania, and agitation. Their usefulness in the treatment of bipolar disorder has also been established. The most widely prescribed atypical antipsychotics include Seroquel (generic name quetiapine), Risperdal (risperidone), Abilify (aripiprazole), Zyprexa (olanzapine) and Geodon (ziprasidone).
Until recently, some atypical antidepressants were FDA approved only for the treatment of schizophrenia, and some had also received approval to treat mania, psychotic agitation and bipolar disorder. In recent years, autism and treatment-resistant depression were added to the list of approved uses. In practice, atypical antidepressants are more often prescribed for off-label uses than the narrow list of FDA approved treatments. Doctors frequently prescribe antipsychotic medications as antidepressants, anti-anxiety drugs, mood stabilizers, cognitive enhancers, hypnotics, and to help control aggressive, impulsive and suicidal tendencies. Antipsychotics have been used to treat:
1) Tourette's syndrome
2) Borderline personality disorder
3) Eating disorders such as anorexia and bulimia
4) Attention deficit hyperactivity disorder
5) Obsessive compulsive disorder
6) Post-traumatic stress disorder
7) Anxiety
8) Nausea
9) Vertigo
10) Stuttering
11) Substance abuse
12) Gambling
13) Insomnia
14) Behavior disorders such as conduct disorder or oppositional defiant disorder
15) Trichotillomania (compulsive hair pulling out of the hair), and even
16) Pedophilia
One recent nursing home study revealed that 30% of the elderly residents were being prescribed antipsychotics, and virtually all of them were for off-label uses such as dementia, delirium, confusion, behavior disorders, anxiety, irritability, aggression and wandering. Another study revealed that about 70 percent of patients under the age of 21 being prescribed antipsychotics were also given them for off label uses, most often to treat conduct disorders, adjustment disorders, anxiety, depression and substance abuse.
This widely accepted practice causes some difficulties in that there are not clearly defined guidelines and criteria for dosages, length of use, possible complications, etc, for off-label uses. There are also concerns that the pharmaceutical companies are engaging in off-label marketing using misrepresentations and inducements to push uses that have yet to be determined to be safe and/or effective. Antipsychotic medications are powerful drugs that can be effective against a variety of psychological conditions, but are not without their side effects, and should not be taken without due consideration.
Why Are Antipsychotics the Top-Selling Drug in America?
By: Alice Wolfe
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