This study of depression treatment in the wake of FDA warnings regarding suicide in children taking antidepressants found that the frequency of depression diagnoses decreased and continues to decrease.  Substitute care did not compensate in non-adult groups and the authors conclude that the spillover effects of the FDA warnings were non-transitory, substantial, and diffuse in a large population.   

Libby, A. M., H. D. Orton, et al. (2009). Persisting decline in depression treatment after FDA warnings. Arch Gen Psychiatry. 66(6), 633-9. http://archpsyc.ama-assn.org/cgi/content/short/66/6/633

Authors: Anne M. Libby, Heather D. Orton, Robert J. Valuck.

This study found that, after years of increased use of antidepressants, a trend reversal began in the early 2000s which included decreasing rates of adequate antidepressant treatment.  The downward trend preceded FDA black-box warnings institute in 2004.   

Harman, J. S., M. J. Edlund, et al. (2009). Trends in antidepressant utilization from 2001 to 2004. Psychiatr Serv. 60(5), 611-6. DOI: 10.1176/appi.ps.60.5.611 http://psychservices.psychiatryonline.org/cgi/content/abstract/60/5/611 

Authors: Jeffrey S. Harman, Mark J. Edlund, John C. Fortne.

This study found that, after the FDA required a black-box warning on antidepressants outlining the possible suicide risk in children, antidepressant use declined sharply over all age groups--including but not limited to children.  The authors conclude that risk communications strategies must be re-considered to ensure intended results. 

Busch, S. H., & Barry, C. L. (2009). Pediatric antidepressant use after the black-box warning. Health Affairs, 28(3), 724-33. DOI: 10.1377/hlthaff.28.3.724 http://content.healthaffairs.org/cgi/content/abstract/28/3/724

Authors: Susan H. Busch, Colleen L. Barry.

This study found no evidence that use of antipsychotic medication in long-term care facilities was associated with increased hospital events or mortality.   

Simoni-Wastila, L., P. T. Ryder, et al. (2009). Association of antipsychotic use with hospital events and mortality among Medicare beneficiaries residing in long-term care facilities. Am J Geriatr Psychiatry, 17(5), 417-27. DOI: 10.1097/JGP.0b013e31819b8936 http://journals.lww.com/ajgponline/Abstract/2009/05000/Association_of_Antipsychotic_Use_With_Hospital.9.aspx

The article explores the shift in prescription coverage for dual eligible mental health patients from Medicaid to Medicare Part D in 2006.  The authors note that a reduction in the number of plans and increases utilization of psychotropic drugs raises concerns about access to medication for individuals with mental illness.  The authors suggest possible changes to Medicare's enrollment and risk-sharing systems. 

Donohue, J. M., H. A. Huskamp, et al. (2009). Dual eligibles with mental disorders and Medicare part D: how are they faring? Health Affairs, 28(3), 746-59. DOI: 10.1377/hlthaff.28.3.746 http://content.healthaffairs.org/cgi/content/abstract/28/3/746 

This study examines M/SU parity laws and their potential effect on out-of-pocket mental health treatment costs.  The study found modest yet important variation in out-of-pocket burden across states but note that prescription drugs account for nearly two-thirds of out-of-pocket spending and fall largely outside the scope of federal M/SU parity laws.  The authors conclude that M/SU parity laws will do little to reduce the observed burden or inter-state variation.  

Zuvekas, S. H., & Meyerhoefer, C. D. (2009). State variations in the out-of-pocket spending burden for outpatient mental health treatment. Health Affairs, 28(3), 713-22. DOI: 10.1377/hlthaff.28.3.713 http://content.healthaffairs.org/cgi/content/abstract/28/3/713 

Authors: Samuel H. Zuvekas, Chad D. Meyerhoefer.