Psych visits increased in 1998; depression cited

Psychiatric prescription costs rose, too

Psychiatrists received 58 million patient visits, the majority for the treatment of depression, during the 12 months ending October 1998, according to recently released data from pharmaceutical consulting firm Scott-Levin in Newtown, PA. That figure represents a 4% increase over the previous 12 months. The top five reasons for those visits, according to Scott-Levin’s Physician Drug & Diagnosis Audit, were:

    • single episode depression (15%);
    • depressive disorder (12%);
    • anxiety states (9%);
    • neurotic depression (7%);
    • recurring-episode depression (6%).

In addition, psychiatrists were responsible for $5.6 billion in retail prescription sales during the year ending October 1998, a 21% increase compared to the previous 12-month period, according to Scott-Levin’s Source Prescription Audit. Psychiatrists wrote 93.1 million retail prescriptions, a 5% increase over the previous 12 months, for an average of 1,185 prescriptions per physician.

Advertising has effect

The top five therapeutic classes prescribed by psychiatrists were:

    • specific neurotransmitter modulators, selective serotonin reuptake inhibitors (SSRIs), and selective norepinephrine reuptake inhibitors (SNRIs) (24.5%);
    • seizure disorder therapies (10.4%);
    • anti-psychotics (9.5%);
    • benzodiazepines (9.3%);
    • similar antidepressants (7.5%).

The Physician Drug & Diagnosis Audit indicates that physicians often use SSRIs and SNRIs, such as Prozac, Zoloft, Paxil, and Serzone, as replacements for tricylic and tetracyclic antidepressants. A Scott-Levin spokesperson notes that direct-to-consumer advertising of antidepressant drugs may at least partially explain the increases in both patient visits to psychiatrists and psychiatric retail prescription sales.

(Editor’s note: For more information, visit the firm’s Web site at