Anti-depressant use doubles

Anti-depressant use among US residents almost doubled between 1996 and 2005, along with a concurrent rise in the use of other psychotropic medications, according to a new report.

The increase seemed to span virtually all demographic groups.

“Over 10 percent of people over the age of six were receiving anti-depression medication. That strikes me as significant,” said study author Dr. Mark Olfson, a professor of clinical psychiatry at Columbia University/New York State Psychiatric Institute in New York City.

According to background information in the study, anti-depressants are now the most widely prescribed class of drugs in the United States. The expansion in use dates back to the 1980s, with the introduction of the antidepressant Prozac (fluoxetine).

The study found that 5.84 per cent of US residents aged six and over were using anti-depressants in 1996, compared with 10.12 per cent in 2005. That’s 13.3 million people, up to 27 million people.

“This is a 20-year trend and it’s very powerful,” remarked Dr. Eric Caine, chair of the department of psychiatry and co-director of the Centre for the Study of Prevention of Suicide at the University of Rochester Medical Centre.

This happened despite a “black box” warning mandated for many anti-depressant medications by the US Food and Drug Administration in 2004, the study authors noted.

Lower rates of increases in anti-depressant use were seen in black people (3.61 per cent in 1996 versus 4.51 per cent in 2005) and in Hispanics (3.72 per cent versus 5.21 per cent in 2005), the researchers found.

Still, about the same number of people were being treated for depression (26.25 per cent in 1996 versus 26.85 per cent in 2005), indicating that the drugs were being used to treat other diagnoses, such as anxiety and other mood disorders.

“The reasons [for the growth] are unclear but they may include the introduction of new anti-depressants over the last 10 to 12 years or so and a broadening in the clinical indications of anti-depressant treatment. Years ago, these drugs were largely focused on depression. Today, more different conditions are treated with antidepressants,” Dr. Olfson said.

“There’s also been an increase in direct-to-consumer advertising and a lessening of the stigma associated with seeking mental health care.”

Indeed, a study released last week found that roughly five of six Americans now have a positive opinion on psychiatric medications, a marked increase from about a decade ago.

Depression may also be more common in the population, or at least more people may be acknowledging it and seeking help, the authors suggested.

“I think part of the increased rate is increased awareness, as well as national depression screening all over the country,” said Dr. M. Beatriz Currier, an associate professor of clinical psychiatry at the University of Miami Miller School of Medicine. “Education and screening decrease stigma.”

Of concern, however, was the finding that the majority of Americans taking anti-depressants were not receiving care from a psychiatrist.

Also troubling was not knowing what the prescriptions were being written for exactly.

“One wonders if the medication is being used as a possible panacea for a number of psychosocial issues which might be better served by counselling,” Dr. Kotrla said.

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