About 15% of adults in US communities meet diagnostic criteria for psychiatric disorders.1 These are even more common in both adult2 and pediatric3 primary care practices, with respective prevalence rates of 27% and 22%. The impact on medical practice is striking, since nonpsychiatrists account for 83% of physician visits in which psychotropic drugs are prescribed.4 Hence, we survey some of the recent developments in psychiatric drug treatment.
Extensive research documents the efficacy of psychopharmacologic treatments for patients with major depression (who often consult primary care physicians for sleep and appetite disturbance and other somatic complaints) or bipolar disorder, with its episodic mania or submanic moods and depression. Major depression, a potentially lethal disorder that is probably increasing among younger birth cohorts,5 is often unrecognized or inadequately treated. Accordingly, the National Institute of Mental Health in 1988 launched its Depression/Awareness, Recognition, and Treatment Program, the first