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Growth in Antidepressant Prescriptions a $10B Paradox

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

That's money that health plans are spending on care that may not be necessary or could be treated with less expensive drugs. With billions of dollars in play,  this prescribing trend has ramifications for public policy and health plan bottom lines.

In a telephone conversation, Ramin Mojtabai, a public health researcher at Johns Hopkins who co-authored the study, stressed that there is no evidence of inappropriate use. "We're just seeing more use of antidepressant among people who may have only vague symptoms like stress or maybe relationship problems."

My doctor was right when she clicked off a list of uses for antidepressants that didn't include, oddly enough, depression.

According to the study, antidepressants are increasingly associated with problems such as tiredness, smoking problems and  headaches. Mojtabai noted that there's little evidence that antidepressants have any effect on these conditions or on milder episodes of depression or anxiety for that matter.

He said there's concern about physician followup. "We don't know if patients are referred to specialists or if they just continue to take the drugs because they are prescribed. Some patients may just stop taking the meds and encounter side effects."

Mojtabai pointed to a couple of reasons for the increase in PCP's prescribing antidepressants.  A shortage of mental health professionals and a lack of insurance coverage top the list. And some people would rather ask  their PCPs for these medications than seek the care of specialists, such as mental health practitioners.

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