Growth in Antidepressant Prescriptions a $10B Paradox

In the study, Mojtabai and his co-author, Columbia University psychiatrist Mark Olfson, suggest that the new provider arrangements such as accountable care organizations will encourage more care coordination between primary care physicians and specialists, including psychologists and psychiatrists. That could help get antidepressant use back in line with clinical efficacy.

The study also makes two chief recommendations to help reduce the frequency of the prescribing of anti-depressants without a psychiatric diagnosis:

1. Improve provider education on how to recognize mental disorders, the treatment limits of antidepressants and the long-term effects.
2. Change drug formularies for antidepressants by creating cost-sharing tiers linked to diagnoses. Cost sharing would be less for patients who are prescribed the medications for recognized clinical conditions.

Mojtabai, who has studied the use of antidepressants for several years, says any policies should also look at how to make sure the drugs get to the people who really need them. "That's the paradox I've seen. Prescribing has increased but the people who really need antidepressants aren't getting them."