Recently published statistics show that the top-grossing medication in the U.S. for 2013 was the antipsychotic Abilify (aripiprazole). The past decade’s dominating pharmaceuticals have been Lipitor (atorvastatin) for high cholesterol and Nexium (esomeprazole) for acid reflux. Nexium was preceded at the top by Prilosec (omeprazole), and before that we had Pepcid (famotidine) and Zantac (ranitidine) somewhere near the top of the sales data. From the late 1960’s to the early 1980’s the tranquilizer Valium (diazepam) was the top grossing drug. Valium rose to the top after the previous few years’ blockbuster tranquilizer Miltown (meprobamate) proved to have significant toxicity risks.
So, this country has gone from treating nervousness and suppressed emotions to heartburn and high cholesterol, both sometimes self-inflicted through dietary indiscretion, to schizophrenia. True, there are other, “softer” indications for Abilify – bipolar disorder, treatment resistant depression and for chemical restraining of aggressive individuals, even children.
One cannot help but stop and reflect on this pharmaceutical sales phenomenon.
A country’s medicine cabinets tell us something about its culture and its predominant issues.
The postwar years, although portrayed in media as a time of optimism and prosperity, were years of great anxiety. My own observation is that many of my patients and acquaintances who were children during World War II lack the emotional imperturbability of those whose childhood fell in the 1930’s, born in the early to mid 1920’s.
The 1950’s and 60’s were times of change, when traditions were lost and values challenged.
At least to this child of the 1950’s, the Lipitor and Nexium years seemed a time of more selfish pursuits for many Americans.
I don’t know what to think of an antipsychotic now topping the pharmaceutical statistics.
Is it a sign of an epidemic rise in rates of serious mental illness, or is it more an indication of the increasing intolerance of negative emotions and behaviors in our society? Or is it just the result of persistent, powerful pharmaceutical marketing to consumers?
Either way, it is a bit disturbing that such drugs outsell all others.
A Country Doctor Writes: 
We’re one of only two countries that allow DTC (direct-to-consumer) advertising of drugs; $hameful!
P Miller MD
Top grossing does not equal top prescribed. Generic simvastatin, generic SSRIs, OTC omeprazole, metformin, ACEi, are still going to be your top prescribed.
And I also think part of it is that we are slowly getting out of the stone ages with mental illness.