Prescriptions for Antidepressants Increasing among Individuals with no Psychiatric Diagnosis

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Americans are no strangers to antidepressants. During the last 20 years the use of antidepressants has grown significantly making them one of the most costly and the third most commonly prescribed class of medications in the U. S. According to the Centers for Disease Control and Prevention, from 2005-2008 nearly 8.9 percent of the U.S. population had at least one prescription in this drug class during any given month. A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health examines national trends in antidepressant prescribing and finds much of this growth was driven by a substantial increase in antidepressant prescriptions by non-psychiatrist providers without any accompanying psychiatric diagnosis. The results are featured in the August 2011 issue of Health Affairs.

Over the past two decades, the use of antidepressant medications has grown to the point that they are now the third most commonly prescribed class of medications in the United States. Much of this growth has been driven by a substantial increase in antidepressant prescriptions by non-psychiatrist providers without an accompanying psychiatric diagnosis. The analysis found that between 1996 and 2007, the proportion of visits at which antidepressants were prescribed but no psychiatric diagnoses were noted increased from 59.5 percent to 72.7 percent. These results do not clearly indicate a rise in inappropriate antidepressant use, but they highlight the need to gain a deeper understanding of the factors driving this national trend and to develop effective policy responses. To the extent that antidepressants are being prescribed for uses not supported by clinical evidence, there may be a need to improve providers’ prescribing practices, revamp drug formularies, or vigorously pursue implementation of broad reforms of the health care system that will increase communication between primary care providers and mental health specialists.

Source: Johns Hopkins Bloomberg School of Public Health
Health Affairs