News and Trends

SEPTEMBER 16, 2011

Antidepressant Use Without Psychiatric Diagnosis Increasing
Americans are taking more antidepressants than ever before, and non-psychiatrists are increasingly willing to prescribe the drugs to patients with no mental health diagnosis, according to research published in the August issue of Health Affairs.

During the past 2 decades, antidepressant use has grown significantly, making it one of the most costly and the third most commonly prescribed class of medications in the United States. According to the CDC, from 2005 to 2008, nearly 8.9% of the US population had at least 1 prescription in this drug class during any given month.

In the study, Ramin Mojtabai, MD, PhD, MPH, and colleagues from the Johns Hopkins Bloomberg School’s Department of Mental Health reviewed a national sample of office-based physician visits by patients aged 18 years and older during a 1-week period using data from the 1996-2007 National Ambulatory Medical Care Surveys.

They found that much of the growth was driven by a substantial increase in antidepressant prescriptions by non-psychiatrist providers without any accompanying psychiatric diagnosis. Between 1996 and 2007, the number of visits where individuals were prescribed antidepressants with no psychiatric diagnoses increased from 59.5% to 72.7%, and the percentage of providers who prescribed antidepressants without a concurrent psychiatric diagnosis rose from 30% of all non-psychiatrist physicians in 1996 to 55.4% in 2007.

“With non-specialists playing a growing role in the pharmacological treatment of common mental disorders, practice patterns of these providers are becoming increasingly relevant for mental health policy,” says Dr. Mojtabai.

Hussar Named Honorary President of APhA
Daniel A. Hussar, PhD, a member of the Pharmacy Times Board of Advisors, was recently elected 2012-2012 Honorary President of the American Pharmacists Association (APhA).

Dr. Hussar is the Remington Professor of Pharmacy at the Philadelphia College of Pharmacy at the University of the Sciences. He is active with a number of state and national professional organizations, and previously served as a member of the APhA Board of Trustees. Dr. Hussar is also a Past President of the Drug Information Association and the Pennsylvania Pharmacists Association, and currently serves on the Board of Directors of Christian Pharmacists Fellowship International.

He will begin serving his term in March of 2012.

APhA also announced that Steven T. Simenson, BSPharm, of Ramsey, Minnesota, was chosen as 2012-2013 President-elect. Dr. Simenson, who serves ad president and managing partner of Goodrich Pharmacy, will succeed Jenelle L. Sobotka to the office of President in March of 2013.

Also elected to serve on APhA’s Board of Trustees, beginning in March 2012, are Jean-Venable “Kelly” R. Goode, PharmD, BCPS, of Richmond, Virginia, and Daniel E. Buffington, PharmD, MBA, of Tampa, Florida. Both will serve a 3-year term beginning in March of 2012. Dr. Goode is professor and director of the Community Pharmacy Residency Program at the Virginia Commonwealth University School of Pharmacy, and Dr. Buffington is president and founder of Clinical Pharmacology Services, an ambulatory care practice.

NCPDP Provides Guidance on Acetaminophen Labels
The National Council for Prescription Drug Programs (NCPDP) is calling for standardization across the industry on the labels of medicines containing acetaminophen. In a new white paper, the organization provided recommendations to ensure consistency across OTC and prescription labels and “make it easier for patients to recognize when prescription medicines contain acetaminophen,” which can lead to safer use.

Currently, standards and regulations for acetaminophen labeling and warnings exist for OTC medicines but not for prescription medicine container labels. OTC medicines include a complete spelling of acetaminophen and concomitant use and liver damage warnings on their labels, while prescription medicine container labels may instead only include an abbreviation, acronym, or truncation of the word acetaminophen, such as “Acet” or “APAP.”

NCPDP is recommending best practices to help patients identify when a prescription medicine contains acetaminophen; compare active ingredients with OTC medicine labels; and avoid unintentional overdose.

The recommendations for prescription container labels for medicine containing acetaminophen include:

  • Using the complete spelling of acetaminophen
  • A standardized acetaminophen concomitant use and liver damage warning label
  • Prioritization of the warning label to print within the top 3 warnings for a medicine

The white paper also includes recommendations to promote patient readability and understanding of the prescription container label, and calls on pharmacists and physicians to participate in patient education on the appropriate use of acetaminophen.

“This represents a critical first step in educating patients about the presence of acetaminophen in many of the most widely prescribed medications, particularly combination products used to treat moderate to severe pain, and to help prevent unintentional acetaminophen overdose and severe toxicity,” said Gerald McEvoy, assistant vice president of drug information at the American Society of Health-System Pharmacists.

To access the white paper, visit