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Keywords:

  • pharmacoepidemiology;
  • psychotropic prescribing;
  • National Ambulatory Medical Care Survey

Objectives

To describe the effect of age on psychotropic coprescribing, psychiatric diagnoses, and other clinical characteristics.

Design

Analysis of the National Ambulatory Medical Care Survey.

Setting

A national sample of outpatient visits to physicians (N = 2,406) in office-based practice in 2010.

Participants

Adults prescribed psychotropic medication (N = 31,229).

Measurements

Office visits at which antidepressant, anxiolytic, sedative, hypnotic, antipsychotic, or mood stabilizer medications were prescribed were grouped according to participant age (21–64, ≥65) and then compared within each medication class on visit characteristics. and then compared according to variables including provider type, sex, and race; presence of diagnosed mental illness; prescription of other psychotropic agents; total number of chronic conditions; time spent with physician; and total number of medications.

Results

In 2010, there were 90.3 million antidepressant office visits; 77.7 million anxiolytic/sedative/hypnotic visits; 15.5 million antipsychotic visits; and 9.5 million mood stabilizer visits. Nonpsychiatrists prescribed the majority of psychotropic medications for every class and age group; 17.3% of older adult antipsychotic visits and 44.9% of younger adult antipsychotic visits were to a psychiatrist (chi-square = 19.58, P = .001). Older adults in every medication class were less likely to have a diagnosed mental disorder.

Conclusion

Older adults prescribed psychotropic medication were less likely to have a diagnosed mental disorder than their younger counterparts. Efforts to promote quality prescribing should seek to minimize nonspecific use of psychotropic medication.