Trends in psychotropic medication use among U.S. adults

PURPOSE: To examine trends and prevalence of prescription psychotropic medication use among noninstitutionalized US adults. METHODS: Prescription medication data from the third National Health and Nutrition Examination Survey (NHANES; 1988-1994; n = 20 050) and the 1999-2002 NHANES (n = 12 060), two nationally representative cross-sectional health examination surveys, were examined for persons aged > or =17 years. RESULTS: The age-adjusted prevalence of psychotropic medication use increased from 6.1% in 1988-1994 to 11.1% in 1999-2002 (p < 0.001). This was due to more than a three-fold increase in antidepressant use (2.5%, 1988-1994 vs. 8.1%, 1999-2002 (p < 0.001)). Significant increases between time periods for antidepressant use were seen for all age, gender, and race-ethnic groups although increases were less pronounced for males than females and non-Hispanic blacks and Mexican Americans than non-Hispanic whites. Prevalence of use remained relatively constant from 1988-1994 to 1999-2002 for anxiolytic/sedative/hypnotic (ASH) medications (3.5-3.8%), antipsychotics (0.8-1.0%), and antimanic agents (0.3-0.4%). The age-adjusted prevalence of multiple psychotropic medication use increased from 1.2% in 1988-1994 to 3.1% in 1999-2002 (p < 0.001). CONCLUSIONS: Psychotropic medication use among US adults increased since 1988-1994, specifically of antidepressants. Increases varied by gender and race-ethnicity indicating under-utilization for non-Hispanic blacks and Mexican Americans compared to non-Hispanic whites for both males and females.