Three Ky. physicians and one nurse practitioner investigated for high numbers of prescriptions for antipsychotic drugs

State and federal officials are investigating three Kentucky doctors and one nurse practitioner because of the unusually high amounts of antipsychotic drug prescriptions they write for Medicaid patients.

In 2008 and 2009, the four wrote the most prescriptions in the state for Abilify, Geodon, Seroquel, Zyprexa and risperidone, antipsychotic drugs that can cost up to $10 a pill, The Courier-Journal's Laura Ungar reports.

Somerset psychiatrist Dr. Zev Zusman wrote 6,556 prescriptions in 2008 and 2009, resulting in $2.2 million in Medicaid charges.

Mount Sterling's Dr. Samuel Welch, left, wrote 5,881 prescriptions, costing taxpayers $1.9 million.

Deborah Bradford, an Owensboro-based nurse practitioner and psychologist, wrote 4,279 prescriptions, at a cost of $1.2 million.

Paducah-based Dr. Duncan Darnell, a child and adolescent psychiatrist, wrote 3,536 prescriptions, costing $1.1 million.

Welch and Darnell defended their practices. Welch, the medical director of Pathways Inc., said he sees about 20 patients a day in a 10-county area. "The biggest chunk of what I do is see patients for medications," he said, adding that other psychologists provide talk therapy.

Darnell, the medical director at Four Rivers Behavioral Health, said he prescribes for more than 1,000 of his own patients, as well as sometimes prescribing for patients cared for by another psychiatrist and a nurse practitioner. "The folks I end up seeing are often very mentally ill," he told Ungar. "For me, medicines are used as a last resort."

Tracking the prescription levels is part of "a federal review into concerns about over-prescribing, waste and health care fraud in an era of tight government budgets," Ungar reports. Sen. Chuck Grassley, R-Iowa, is leading the review, and has asked every state to list the top 10 prescribers for certain medications. (Read more)