Increase in Number of Non-Mental Health Professionals Prescribing Antidepressants

A recent study has revealed an alarming increase in the amount of antidepressants being prescribed in America. “Most of the recent increase in antidepressant use is a consequence of the growing number of prescriptions written by physicians who are not psychiatrists,” said Ramin Mojtabai, associate professor at the Johns Hopkins Bloomberg School of Public Health and co-author of the study. “In the United States, nearly four out of every five antidepressant prescriptions are written by such providers.” This dynamic has raised concern for the mental health field. “In fact, antidepressants have been demonstrated to be clinically effective for only a limited number of psychiatric conditions-major depressive disorder, chronic depression (also known as dysthymic disorder), some anxiety disorders, and a few other well defined conditions,” said Mojtabai. “In one study of privately insured plans, a majority (61.4 percent) of patients for whom antidepressants were prescribed did not receive diagnoses for any psychiatric disorders during the course of a year. In addition, there are concerns about side effects and costs of antidepressant use.”

Using data from a longitudinal survey conducted by the CDC, Mojtabai isolated the types of symptoms that were warranting the antidepressants, as well as how often they were being prescribed, and found that many doctors were prescribing antidepressants for mild psychological issues that did not meet full diagnostic criteria. “However, meta-analyses of randomized clinical trials using placebos demonstrate that antidepressants have little or no therapeutic effect on these milder conditions,” said Mojtabai. The overall results of the study were alarming. Mojtabai added “At the practice level, the share of providers who prescribed antidepressants without a concurrent psychiatric diagnosis in any of their sampled visits increased from 30.0 percent in 1996 to 55.4 percent in 2007. Among practices with any antidepressant visits lacking concurrent psychiatric diagnoses, the average number of such visits increased by approximately 36 percent during the study period.” This trend is becoming more common, but often, the medical professionals prescribing the antidepressants are not qualified to diagnose the mental health problems accurately, and some patients do not receive the care they need.

Mojtabai, Ramiri, and Mark Olfson. “Proportion Of Antidepressants Prescribed Without A Psychiatric Diagnosis Is Growing.” Health Affairs 30.8 (2011): 1434-442. Print.

© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • JB


    November 4th, 2011 at 3:08 PM

    This comes as no surprise to me. The first time I experienced depression in my own life I went to my family doctor first because I knew that something was rong with me but I could not quite put my finger on it. He saw me one time, and while he did refer me ot to a psychiatrist for follow up, he also automatically wrote me a prescription for Prozac. I did not think anything about it at the time, but when I scheduled with the other doctor he was kind of surprised that the family doc had so readily written that out for me. He did not think that was the best option for me so I decided to follow his treatment instead. It was ultimately successful for me, but I wonder about the others who have experienced this and have not give it a second thought.

  • Kate


    November 5th, 2011 at 5:06 AM

    @JB but you went to a doctor at first that you trusted right? So why not trust that his decision to put you on an anti depressant was the right one? I am sure that he did not prescribe anything to you that would cause you any harm, only a medicine that could indeed help alleviate your depressive symptoms. Are you ever going to get any two professionals to always agree on the ebst course of treatment? Probably not. I am glad that you finally did find someone who helped you, but I don’t think that that necessarily makes the other so wrong.

  • jess


    November 6th, 2011 at 6:14 AM

    Why don’t doctotrs stick with what they know? Don’t go messing in areas that you don’t know anything about.

  • Dr.


    November 6th, 2011 at 11:54 AM

    I’m a doctor and let me tell you there is no measure for a person’s health.Its not like we put a meter on the patient,take the readout,refer to a manual and then decide whether to prescribed medicines or not.It is far more complicated than that.There are no meters,no read-outs and no manuals,its all done on a case by case basis and really,it could also be because sometimes a doctor may not want to risk anything and may thus prescribe medicines for the patient.



    November 6th, 2011 at 11:20 PM

    One tricks your body into believing there is no problem and its effect is temporary-the other gets to the root of the problem and tries to solve it permanently. First option is meds and the second is therapy-take you pick,people!

  • Jane


    November 7th, 2011 at 5:20 AM

    But the patients and the insurance companies are driving this trend!
    Patients want an all purpose doctor, someone who will see them and diagnose and treat everything.
    And the insurance companies want the patient to stay with a general doctor because they do not want to have to reimburse for the higher fees that a specialist is going to charge.
    So really I am scared that everyone has lost sight of the best treatment methods for the common patient.

  • DavidWiley


    November 12th, 2011 at 11:14 PM

    If you’re not a psychiatrist then what business do you have prescribing antidepressants anyway? Is that even legal for a doctor to do? Hand out pills for things he is not qualified to diagnose and out of his area of expertise? That seems very wrong!

  • PaigeKeith


    November 12th, 2011 at 11:41 PM

    @DavidWiley–Cool your jets there, David. He is legally and medically qualified to diagnose it. He’s just not go on to specialize in mental health too like a psychiatrist has.

    I agree though in part. Nowadays it’s apparently perfectly acceptable for a doctor to prescribe whatever he pleases for any condition he thinks you may have, regardless of whether he’s particularly knowledgeable on the matter or you could write what he knows about it on the head of a pin.

    Considering most of those prescriptions are given there by doctors who are NOT qualified makes me wonder how many “depressed” people are not and would not be diagnosed as such by a psychiatrist.

  • Gino Ramirez

    Gino Ramirez

    November 12th, 2011 at 11:54 PM

    Never mind that, this is why our health insurance plans cost a king’s ransom. Prescribing antidepressants without a diagnosis for a psychiatric disorders?? Appalling.

    The healthcare insurance providers can put a quick stop to that by refusing to cover any claims that didn’t have a diagnosis on record. They would be doing all those men and women a favor that don’t truly need them if it makes the doctors think twice about prescribing them.

  • Rex Halloran

    Rex Halloran

    November 13th, 2011 at 6:42 PM

    @PaigeKeith–Acceptable? No, it’s not. We are already a nation doped up on every pill for every ailment. We use this as a cop-out for actually getting genuine treatment and resolutions to our life problems that are at their root. It’s dis-ease, not disease.

    Too many doctors are too quick to reach for the prescription pad and too many patients expect that. Instead they should be talking at length with their patients about referring them for therapy.

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