59.5% of antidepressant prescriptions were made with no diagnosis in 1996, in 2007 the figure rose to 72.7%, researchers reported in Health Affairs. Antidepressant drugs are today the third most commonly prescribed class of drugs in the USA.
Nearly 8.9% of the American population had at least one antidepressant prescription during any given month during the period 2005-2008.
A good proportion of this growth in antidepressant prescription has been by non-specialist providers whose patients were not diagnosed by a psychiatrist.
Ramin Mojtabai, MD, PhD, MPH, lead author of the study and an associate professor with the Bloomberg School's Department of Mental Health, said:
"We've seen a marked increase in antidepressant use among individuals with no psychiatric diagnosis. Nearly four out of every five antidepressant prescriptions are written by non-psychiatrist providers."
2.5% of all visits in 1996 to doctors who were not psychiatrists resulted in a prescription for antidepressant medications. In 2007, the figure rose to 6.4%. During the same period, prescriptions for antidepressants made out by primary care physicians (general practitioners) for non-psychiatric disorders rose from 3.1% to 7.1%.
Antidepressant prescriptions made out to patients who had been diagnosed by a psychiatrist rose only from 1.7% to 2.4% during the 1996-2007 period, the researchers found.
The authors stress that their findings do not demonstrate inappropriate use of antidepressants. However, they emphasize the need to determine exactly what is driving this national trend.
The authors concluded:
"To the extent that antidepressants are being prescribed for uses not supported by clinical evidence, there may be a need to improve providers' prescribing practices, revamp drug formularies, or vigorously pursue implementation of broad reforms of the health care system that will increase communication between primary care providers and mental health specialists.
Written by Christian Nordqvist