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 GoodTherapy.org.
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