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Growth in Antidepressant Prescriptions a $10B Paradox

Margaret Dick Tocknell, for HealthLeaders Media, August 10, 2011

A few years ago, a new primary care physician explained to me that among her many services she could also write my prescriptions for any drugs I might need, including , she said, antidepressants.

Her offer surprised me. I told her that if I were taking an antidepressant, I would to also need  therapy care from a psychologist or psychiatrist. She explained that antidepressants are prescribed for everything from anxiety to weight control and that she was very confident in her ability to match the pill with the patient.

I thought about that conversation this week when I read a study about the increase in antidepressant prescribing by primary care physicians. According to the studying the August issue of Health Affairs, these medications are routinely prescribed by PCPs for uses that may not be supported by clinical evidence. "Many people view psychiatric medications as enhancers of personal and social well-being, providing benefits well beyond these medications clinically approved uses," the study says.

Analyzing office visit data from 1996-2007 compiled by the Centers for Disease Control and Prevention, the study found that more than 9% of PCP visits resulted in prescriptions for antidepressants, but in only 44% of those cases was there a diagnosis of depression or anxiety disorder.

The typical patient who gets a scrip for antidepressants is more than 50 years old and has a chronic condition – such as diabetes, hypertension, heart disease or asthma ?? that may contribute to symptoms of depression.

Big bucks are involved. Antidepressants are the third most commonly prescribed medication class in the U.S. with annual sales of about $10 billion.

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