Rank Brand Name Generic Name # of U.S. Prescriptions Use
10 Valium Diazepam 14,009,000 Anxiety, Panic disorder
Benzodiazapene – Positive allosteric modulation of GabaA Receptors – (Facilitates GabaA inhibition in use dependent manner)
9 Effexor XR Venlafaxine 14,992,000 Depression,Anxiety, Panic disorder – “Off-label” for diabetic neuropathy and migrane
Serotonin-norepinephrine reuptake inhibitor (SNRI) – increases serotonine and norepinephrine
8 Seroquel Quetiapine 15,814,000 Schizophrenia, Bipolar disorder, “add-on” for Depression
“Atypical antipsychotic” – Blocks dopamine, serotonin, adrenergic and histamine receptors
7 Cymbalta Duloxetine 16,626,000 Depression,Anxiety, fibromyalgia, diabetic neuropathy
Serotonin-norepinephrine reuptake inhibitor (SNRI) – increases serotonine and norepinephrine in a use dependent manner
6 Desyrel Trazodone 18,873,000 Depression, Bipolar Depression (sometimes), Anxiety
Predominantly a 5-HT2A receptor antagonist, also 5-HT1A partial agonist and Selective Serotonin Reuptake inhibitor (SSRI)
5 Prozac Fluoxetine 19,499,000 Depression, Anxiety, OCD, Bulemia, PMDD
Selective Serotonin Reuptake inhibitor (SSRI), 5-HT2C receptor antagonist, σ1 Receptor agonist
4 Zoloft Sertraline 19,500,000 Depression,Anxiety, OCD,PTSD, PMDD
Selective Serotonin Reuptake inhibitor (SSRI) – Weak σ1 receptor agonist and α1-adrenoreceptor antagonist
3 Ativan Lorazepam 25,868,000 Anxiety, panic disorder
Benzodiazapene – Positive allosteric modulation of GabaA Receptors – (Facilitates GabaA inhibition in use dependent manner)
2 Lexapro Escitalopram 27,698,000 Depression,Anxiety
Selective Serotonin Reuptake inhibitor (SSRI)
1 Xanax Alprazolam 44,029,000 Anxiety
Benzodiazapene – Positive allosteric modulation of GabaA Receptors – (Facilitates GabaA inhibition in use dependent manner)
- 10. Hydrochlorothiazide (various brand names) lowers blood pressure — 47.8 million
- 9. Generic Glucophage (metformin) diabetes drug — 48.3 million
- 8. Amoxicillin (various brand names) antibiotic — 52.3 million
- 7. Azithromycin (brand names include Z-Pak and Zithromax), antibiotic — 52.6 million
- 6. Generic Prilosec (omeprazole), antacid drug — 53.4 million (does not include over-the-counter sales)
- 5. Generic Norvasc (amlodipine besylate), angina/blood pressure drug — 57.2 million
- 4. Generic Synthroid (levothyroxine sodium), synthetic thyroid hormone — 70.5 million
- 3. Lisinopril (brand names include Prinivil and Zestril), blood pressure drug — 87.4 million
- 2. Generic Zocor (simvastatin), cholesterol-lowering statin drug — 94.1 million
- 1. Hydrocodone (combined with acetaminophen), opiate/painkiller — 131.2 million
This list doesn’t contain any psychiatric drugs–Xanax just barely misses the cut–but the #1 drug, hydrocodone, is psychoactive. However, while our #1 psychiatric drug did not make it into the top 10 most prescribed, our #8 drug, the atypical antipsychotic Seroquel clocks in at #6 on the drugs we spend the most money on (shown bellow).
Also of note, is the #1 most prescribed drug for teenagers. Can you guess what it is? Methylphenidate, Ritalin, the ADHD medicine. I’m most surprised it’s not adderall at this point.
According to ABC news: “The United States makes up only 4.6 percent of the world’s population, but consumes 80 percent of its opioids — and 99 percent of the world’s hydrocodone, the opiate that is in Vicodin.” Our use of hydrocodone and other opiate painkillers has many issues: such as diversion and abuse, and use as a bandage in chronic pain or injury instead of treating underlying issues (and where it may make pain worse in the long term). Another startling new trend, is the spike in newborns born dependent on opiates:
The best sellers are often generic drugs, so it is also interesting to see where “big pharma” is making the most money:
Top 10 drug we spend the most money on in the United States overall (according to IMS Institute for Healthcare Informatics in 2011)
- 10. Epogen, injectable anemia drug — $3.3 billion
- 9. Actos, diabetes drug — $3.5 billion
- 8. Crestor, cholesterol-lowering statin drug — $3.8 billion
- 7. Singulair, oral asthma drug — $4.1 billion
- 6. Seroquel, antipsychotic drug — $4.4 billion
- 5. Abilify, antipsychotic drug — $4.6 billion
- 4. Advair Diskus, asthma inhaler — $4.7 billion
- 3. Plavix, blood thinner — $6.1 billion
- 2. Nexium, antacid drug — $6.3 billion
- 1. Lipitor, cholesterol-lowering statin drug — $7.2 billion
Note the atypical antipsychotics Seroquel and Abilify. I’m also shocked that antacid drugs can make that much money, but I guess it’s in a different ballpark than Tums.