According to a report released last week by the US Government, psychiatrists wrote 29 percent of new antidepressant orders, followed by GPs and primary care doctors. Between 2002 and 2005, prescriptions filled for antidepressant drugs increased from 154 million to 170 million. The analysis, conducted by the Agency for Healthcare Research and Quality, indicated that antidepressant prescriptions—and this does not include refills—written after doctors spoke with patients either in person or over the phone increased by 16 million over the past 3 years. The data used came from the Medical Expenditure Panel Survey of health services used by Americans.
- 29 percent of prescriptions were written by psychiatrists
- 23 percent of prescriptions were written by GPs
- 21 percent were written by family practitioners
- 10 percent were written by internal medicine specialists.
GPs provide primary care, but are specialty-trained; family practitioners are primary care physicians who complete a residency in family medicine; and internal medicine specialists complete a residency in internal medicine and focus on the diagnosis and non-surgical treatment of adults with illnesses that are difficult to diagnose or manage.
Meanwhile, Dr. Martin Keller, head of psychiatry at Brown University, is likely to be the next target in ongoing congressional investigations into the often too-friendly relationship between some doctors and pharmaceutical companies. Senator Charles E. Grassley—Republican-Iowa—the ranking member of the Senate Finance Committee is looking at consulting fees Keller received from drug companies for his research on the antidepressant Paxil. Meanwhile, Alison Bass, a former Globe reporter who wrote a book on Keller’s research and the legal trial and fallout, said the move was a long time coming. Keller has never been publicly disciplined or sanctioned for his role in a study that hid the negative consequences of Paxil while promoting only positive outcomes. Despite this, “he is still chief of psychiatry [at Brown] and pulling in millions of dollars in research funding from the drug companies and federal research agencies,” Bass said.
Studies have shown that researchers paid by a company are more likely to report positive findings when evaluating that company’s drugs. Also, a Vermont study found that on average, psychiatrists who received at least $5,000 from makers of newer-generation antipsychotic drugs appear to have written three times as many prescriptions to children for the drugs as psychiatrists who received less or no funding. The drugs prescribed are not approved for most uses in children, who appear to be especially susceptible to the side effects.
Recently we reported that Grassley was demanding the American Psychiatric Association provide an accounting of its financing. “I have come to understand that money from the pharmaceutical industry can shape the practices of nonprofit organizations that purport to be independent in their viewpoints and actions,” Grassley said in a letter to the association. In 2006, the latest year for which numbers are available, the drug industry accounted for about 30 percent of the association’s $62.5 million in financing, with half that money going to drug advertisements in psychiatric journals and exhibits at the annual meeting; the remainder sponsored fellowships, conferences, and industry symposiums at the annual meeting.