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Antidepressants widely prescribed for unclear diagnosis

Kathleen Blanchard's picture

More people are taking antidepressants, but exactly why isn’t always clear. According to a Johns Hopkins study, antidepressant use has been on the rise in the past twenty years.

Four out of every five prescriptions are written by general health care practitioners, rather than by psychiatrists; for patients with poorly defined. or minor psychiatric disorders.

In their investigation, the Hopkins team examined antidepressant trends from the CDC. They found more patients are taking antidepressant prescriptions with no clearly defined mental health diagnosis. Between 1996 and 2007 prescriptions increased from 59.5 percent to 72.7.

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The number of primary care versus psychiatry prescribers of antidepressants rose from 30 percent in 1996 to 55.4 percent in 2007.

Current recommendations include antidepressant use for major depression and for specific diagnoses, but more general practitioners have been prescribing the drugs for less severe mental health problems.

Ramin Mojtabai, M.D., Ph.D, MPH, lead author of the study and an associate professor with the Bloomberg School’s Department of Mental Health explains the significance of the finding: “With non-specialists playing a growing role in the pharmacological treatment of common mental disorders, practice patterns of these providers are becoming increasingly relevant for mental health policy.”

Dr. Mojtabai says there may be a need for primary care physicians to boost communication with mental health specialists. “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 undertake broad reforms of the health care system that will increase communication between primary care providers and mental health specialists.”

Health Affairs: doi: 10.1377/hlthaff.2010.1024
"Proportion Of Antidepressants Prescribed Without A Psychiatric Diagnosis Is Growing"
Ramin Mojtabai and Mark Olfson
August, 2011