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More Antidepressants Prescribed for Non-Psychiatric Disorders

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Researchers from Johns Hopkins University in Baltimore, Maryland and Columbia University in New York find that the rapid growth of prescriptions for antidepressant medications has been fueled by orders from non-psychiatrist providers and without any psychiatric diagnosis. The paper by Ramin Mojtabai of Johns Hopkins and Columbia’s Mark Olfson appears in the August 2011 issue of the journal Health Affairs (paid subscription required).

The authors note that 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 of antidepressants during any given month.

The findings were based on data from the 1996-2007 National Ambulatory Medical Care Surveys. From those data, researchers reviewed a national sample of office-based physician visits by patients ages 18 and older during a one-week period.

The researchers conducted two sets of logistic regression analyses, comparing antidepressant visits lacking psychiatric diagnoses with antidepressant visits including psychiatric diagnoses and visits lacking both prescriptions for antidepressants and psychiatric diagnoses. The team also assessed physician practice-level trends in antidepressant visits without psychiatric diagnosis and found that in the general medicine practice, antidepressant use was concentrated among people with less severe and poorly defined mental health conditions.

The results showed most prescriptions for antidepressants being made by non-psychiatrists, and going to patients without psychiatric conditions. “Between 1996 and 2007, the number of visits where individuals were prescribed antidepressants with no psychiatric diagnoses increased from 59.5 percent to 72.7 percent,” says Mojtabai, “And the share of providers who prescribed antidepressants without a concurrent psychiatric diagnosis increased from 30 percent of all non-psychiatrist physicians in 1996 to 55.4 percent in 2007.”

“To the extent that antidepressants are being prescribed for uses not supported by clinical evidence,” adds Mojtabai, “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.”

Read More:Global Study Identifies Top Mental Health Challenges

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