Re: “Psychiatric Medication Users by Age and Sex”

To the Editor: In “Psychiatric Medication Users by Age and Sex,” the author found that the reported use of psychiatric medications increased from 1999 to 2018.¹ There were no comments regarding the effectiveness or benefits of this change, but the study evidenced the burden of mental health in the United States. With this growth in pharmacotherapy, there is a need to emphasize comprehensive mental health treatment by advocating for psychotherapy in primary care settings.

Evidence promotes psychotherapy as a core component of mental health treatment, especially in combination with medication.² Psychotherapy has been shown to provide long-term coping strategies, decrease hospitalizations and relapses, and increase quality of life.^2,3 When used in combination with medication, psychotherapy can decrease medication doses and improve adherence.³ These benefits are critical because 80% of adults with depression currently report difficulties with daily life.⁴ This burden persists despite increased prescribing while psychotherapy is used in a minority of cases across all age groups.⁵ Psychotherapy is underused because of insufficient access to trained providers and inflated pharmaceutical marketing pushing patients and providers to prioritize medication.³ Despite these barriers, patients prefer psychotherapy over pharmacotherapy.⁶

Many patients benefit from psychiatric medications as an important part of their treatment, but psychotherapy's underuse may be limiting these patients' full potential for recovery. Psychotherapy is underused yet desired by patients. Primary care physicians should include psychotherapy in patients' treatment plans to maximize outcomes.