"Psych meds spike among younger troops"
By Andrew Tilghman and Brendan McGarry – Staff writers
Posted : Friday Sep 3, 2010 12:14:35 EDT
Use of psychiatric medications among people ages 18 to 34 mostly active-duty troops and their spouses is rising at a significantly higher rate than other age groups in the military health care system, according to data newly released to Military Times.
Overall, the number of prescriptions filled for psychiatric medications rose 42 percent from 2005 to 2009 among Tricare beneficiaries in that age group, according to data provided by Tricare Management Activity in response to a Freedom of Information Act request.
That compares to an increase of 24 percent among Tricare beneficiaries ages 45 to 64, mostly retirees. For children 17 and younger, the increase was 18 percent.
All the increases outpace overall growth in the Tricare population over the same period.
Anti-depressants like Zoloft, Wellbutrin and Celexa account for slightly more than half of the prescriptions in this age group. But increasingly, young adults in the military and their spouses are turning to other types of psych meds to treat their mental health problems.
Prescriptions for stimulants, including amphetamines and drugs to treat attention-deficit disorders, more than doubled. And claims for anti-psychotics like Seroquel and Abilify nearly doubled from 2005 to 2009 among beneficiaries ages 18 to 34, the Tricare data show. Seroquel is often used to treat nightmares and sleeping problems related to post-traumatic stress disorder.
The rise and potential dangers of psychiatric drug use is a growing concern for many military officials and doctors.
Navy Capt. Paul Hammer, director of the Naval Center for Combat and Operational Stress, raised concerns about prescription drugs when speaking to military doctors at a recent conference on treating traumatic brain injury.
“Prescribe with care,” Hammer told hundreds of health care workers at the Aug. 30 conference in Washington, D.C.
“A lot of neurotransmitters” are involved when troops suffer from complex combinations of mild traumatic brain injury, PTSD, depression, anxiety and substance abuse issues, he said.
Cocktails of psychiatric drugs can, in some cases, cause patients to get worse, doctors say.
“Sometimes … as providers we induce some of the [symptoms], and I would be cautious if someone does develop worsening symptoms six months after the event,” said Dr. Joel Scholten, the head of rehabilitation services at the Veterans Affairs Medical Center in Washington, D.C., also speaking at the TBI conference.
Army Gen. Peter Chiarelli on July 29 issued a report about the Army’s spike in suicides, noting that some psychiatric drugs including Paxil and Zoloft, the only two approved for PTSD come with warnings about the potential for increased risk for suicide.
The Army should “conduct research to identify appropriate antidepressant medications that are beneficial to the treatment of depression and anxiety, but that will not increase risk for suicidal behavior,” according to one of the report’s recommendations.
The Army also should “conduct comprehensive research and analysis of the impact of increased use of antidepressant, psychiatric and narcotic pain management medications on the force,” the report said.
Last year, the Army issued a series of policies designed to reduce the risks linked to multi-drug use. Another policy is expected out later this year.
Military death records obtained by Military Times show that at least 68 accidental drug deaths in 2009, up from 24 in 2001. In total, at least 430 troops have died from drug use or, in a small number of cases, alcohol use in the past decade.
Other trends from 2005 through 2009 revealed in the Tricare prescription data:
•Anti-depressants remain the most commonly used type of psychiatric drug among Tricare beneficiaries, accounting for or half of all prescribed mental health medications.
•Anti–convulsants and anti-epileptics such as Topamax and Neurontin increased 56 percent among beneficiaries 18 to 34.
•Anti-anxiety medications such as Klonopin and Xanax climbed 72 percent among beneficiaries 18 to 34.