Healthy Skepticism Library item: 16168

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Publication type: news

Ostrow N.
Antidepressant Use in U.S. Doubled Over Decade to 10% in 2005
Bloomberg.com 2009 Aug 3
http://www.bloomberg.com/apps/news?pid=20601202&sid=ahhoI_iSoraM

Full text:

The number of Americans taking antidepressants doubled to 10.1 percent of the U.S. population in 2005 compared with 1996, increasing across income and age groups, a study found.

An estimated 27 million U.S. people ages 6 and older were taking the drugs by 2005, while their use of psychotherapy declined, according to Columbia University research. Each person treated for depression in 2005 also filled more prescriptions, an average of 6.9 that year compared with 5.6 in 1996, said the study published in the August issue of the Archives of General Psychiatry.

The surge in antidepressant use propelled that class of treatments to become the top-selling U.S. medicines in 2005, surpassing blood-pressure prescriptions, the study said. Those findings highlight the need for doctors who aren’t psychiatrists and who prescribe these medicines to be trained to diagnose and manage depression so patients get the most effective treatment, said the lead author Mark Olfson.

Rising use of the drugs “may involve the introduction of new antidepressants, the increase in the direct-to-consumer advertising, lessening stigma with seeking mental health care” and more Americans acknowledging they are depressed, said Olfson, a professor of clinical psychiatry at Columbia University and New York State Psychiatric Institute in New York, in a July 31 telephone interview. “The reasons for this increase are not clear.”

Antidepressant Sales

The trend fueled sales of such antidepressants as Eli Lilly & Co.’s Prozac, Forest Laboratories Inc.’s Celexa and Pfizer Inc.’s Zoloft. The research found more growth in the class of antidepressants known as selective serotonin reuptake inhibitors and a decline in tricyclic antidepressants.

The researchers analyzed U.S. data from the 1996 and 2005 Medical Expenditure Panel Surveys, sponsored by the Agency for Healthcare Research and Quality, which provide national estimates on health-care usage and costs. The 1996 survey found 5.8 percent of 18,993 people surveyed took antidepressants, compared 10.1 percent of the 28,445 people surveyed in 2005.

The results also showed a jump in the use of antidepressants across demographic groups, with the exception of blacks. The rate of use of the medicines among blacks in 2005 was 4.5 percent, less than half that of whites. The rate for Hispanics increased to 5.2 percent in 2005 from 3.7 percent in 1996. Among all races, the percentages of men and women of all ages, marital status and educational levels taking antidepressants in 2005 rose from 1996, the study showed.

Diagnoses Rise

Olfson said it’s unclear if more people are depressed or if more people are just taking antidepressants. Other studies have found diagnoses of major depression in adults increased from 3.3 percent in 1991-1992 to 7.1 percent in 2001-2002, according to the journal article.

The new research found a decline in nondrug therapy. About 20 percent of people being treated with antidepressants also underwent psychotherapy in 2005 compared with almost 32 percent in 1996, the data showed.

“There’s being a greater emphasis placed on medications rather than psychotherapy in treating mental health problems,” Olfson said. “I hope these numbers will draw attention to how many people are being prescribed these medications.”

Cost Impact

Olfson said the decline in therapy may be because people have to pay more out of pocket for that treatment. He said depressed people not under the care of a psychiatrist don’t typically follow through with their treatment or stay on their medicines long enough to improve. Medicine and therapy in combination are proven to be more effective than either treatment alone, he said.

The number of children ages 6 to 17 who took antidepressants jumped 78 percent in 2005 from 1996, Olfson said, from a rate of 1.4 per 100 children to 2.6 per 100. The increase continued after the U.S. Food and Drug Administration in October 2004 issuing a “black box” warning that antidepressants increase the risks of suicide in children and adolescents.

The study was sponsored by the Agency for Healthcare Research and Quality and the National Alliance for Research on Schizophrenia and Depression.