The Over-Prescription of Antidepressants, Even Against Guidelines

The over-prescription of antidepressants and other medications in situations where psychotherapy should be a first recourse (and may very well be all the treatment needed) is increasingly common. A new report finds that in many cases, clinicians are going a step further. Many are prescribing antidepressants in very specific instances when their use is explicitly not recommended by widely accepted guidelines. Specifically, people diagnosed with bipolar disorder are receiving prescriptions for antidepressants during periods of mania, exactly a time at which antidepressants are not recommended as a course of treatment for the person’s emotional and behavioral state.

This is not to say that people diagnosed with certain mental health challenges do not benefit from prescription drugs. In some of the most serious cases, the combination of medication and psychotherapy has found to bring the greatest benefit to the patient: more benefit that either approach alone. But this report brings up a stark concern: what are the motivations of clinicians who go against recommendations, which are set in place for the benefit of patients, by prescribing medication when it is not recommended? In the study cited here, people who were described antidepressants during episodes of mania had significantly higher rates of depression after coming back down compared to people who were not given the drugs.

Psychotherapy may not be the single cure-all treatment for every single person’s issues. Many people benefit from relaxation techniques such as mindfulness, meditation, and yoga, Others find balance through exercise or sports, or find outlet in visual art, music, and other hands-on, creative activities. But quite often, it is a combination of approaches that brings the greatest amount of growth and healing. Simply throwing a drug at the concern is neither effective nor safe. As more reports shed light on the way mental health issues are treated in various sectors of the health and mental health fields, perhaps this transparency encourages a higher level of responsibility among professionals of all stripes.

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The preceding article summarizes research or news from periodicals or related source material in the fields of mental health and psychology. GoodTherapy.org did not participate in or condone any studies, or conclucions thereof, that may have been cited. Any views or opinions expressed are not necessarily shared by GoodTherapy.org.

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  • T milner

    September 21st, 2010 at 10:53 AM

    ” what are the motivations of clinicians who go against recommendations, which are set in place for the benefit of patients, by prescribing medication when it is not recommended?”
    I say the motivation is nothing but money and some of these so-called ‘professionals’ take money from companies making these sometimes-expensive medicines to actually help their business!

  • Pearl

    September 21st, 2010 at 11:28 AM

    That is shocking that clinicians are prescribing anti-depressants when they know full well it could make things worse. Why on earth do they even have a practice if it’s known they are doing so???

  • arlene

    September 21st, 2010 at 1:22 PM

    In every profession, there are bad apples that spoil the barrel. Clinicans aren’t any different in that respect. However the results of their decisions are more life changing than most. I hope they were reported for this and disciplinary action follows. But then breaking guidelines probably isn’t considered as bad as breaking rules.

  • Olivia

    September 21st, 2010 at 2:45 PM

    14% of 2416 people is 338. That’s 338 lives that could by now have been better managed had their clinicians taken on board the existing evidence and abided by the guidelines. Is it any wonder that some patients have such a distrust of them and their competence? Unfortunately this taints the patient’s view of all clinicians, including those that respect the guidelines.

  • kimi

    September 21st, 2010 at 7:12 PM

    its not necessary that this happens because they have taken money or are not competent enough.it may be just because they do not want to take a change and prescribe drugs anyway instead of taking a chance and not prescribing enough.

    so being angry is not going to help.better awareness regarding this among the group of professionals is what is required.

  • Bonnie

    September 22nd, 2010 at 4:41 AM

    How many times have you heard people complaining that they went to see the doctor but he gave them no meds for what was wrong with them? they may only have a virus but think that they need an antibiotic and talk about it so vocally that eventually many doctors will write a prescription just to get the to shut up. Don’t you think the same is true with anti depressants? they give in the pressure because this is what the public wants.

  • Hannah g

    September 22nd, 2010 at 11:08 AM

    hey kimi,it may be because they do not want to take a chance but they also need to know the real importance of their profession and need to realize the severity of the results that they take decisions or chances regarding.

  • Danielle

    September 24th, 2010 at 10:10 AM

    arlene you said “But then breaking guidelines probably isn’t considered as bad as breaking rules.”

    There’s a simple answer. Guidelines need to hardened into rules if it’s so easy to disregard them and not worry about the consequences. The well-being of these bipolar patients depends upon it. Who knows how many more are out there that weren’t included in the study’s sampling that are affected like this?

  • Beatrice

    September 24th, 2010 at 3:22 PM

    I am horrified! Is it laziness or is it arrogance that makes them feel they can ignore the mania episode guidelines for bipolar disorder? This is totally unacceptable. The researchers should be naming and shaming every single one of them.

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