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Antidepressant Use Increasing In The United States

Increase seen in nearly all socio-demographic groups

By James Limbach
ConsumerAffairs.com

August 4, 2009

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The use of antidepressants among Americans older than 6 years is on the rise.

"Several factors may have contributed to this trend, including a broadening in concepts of need for mental health treatment, campaigns to promote mental health care and growing public acceptance of mental health treatments," the authors write in the August issue of Archives of General Psychiatry. "In parallel with growth in mental health service usage, psychotropic medications have become increasingly prominent in treatment."

Antidepressants are now the most commonly prescribed class of medications in the United States.

Mark Olfson, M.D., M.P.H., of Columbia University Medical Center and New York State Psychiatric Institute, New York, and Steven C. Marcus, Ph.D., of the University of Pennsylvania, Philadelphia, analyzed data from the 1996 and 2005 Medical Expenditure Panel Surveys.

A total of 18,993 individuals age 6 and older were included in the 1996 survey and 28,445 in the 2005 survey. A designated adult in each household responded to questions regarding medical visits, prescriptions, conditions for which they were treated and other variables.

Between 1996 and 2005, the rate of antidepressant treatment increased from 5.84 percent to 10.12 percent or from an estimated 13.3 million to 27 million individuals.

"Significant increases in antidepressant use were evident across all socio-demographic groups examined, except African Americans, who had comparatively low rates of use in both years (1996, 3.61 percent; 2005, 4.51 percent)," the authors write. "Although antidepressant treatment increased for Hispanics, it remained comparatively low (1996, 3.72 percent; 2005, 5.21 percent)."

Among antidepressant users, the percentage that was also prescribed antipsychotic medications increased between 1996 and 2005 (5.46 percent vs. 8.86 percent), but fewer also underwent psychotherapy (31.5 percent vs. 19.87 percent).

"Together with an increase in the number of antidepressant prescriptions per antidepressant user [an average of 5.6 vs. 6.93 per year], these broad trends suggest that antidepressant treatment is occurring within a clinical context that places greater emphasis on pharmacologic rather than psychologic dimensions of care," the authors write.

Beyond the general expansion of mental health treatment, several factors may have contributed to the overall increase in prescriptions, they note. First, major depression may have become more common. The Food and Drug Administration (FDA) approved several new antidepressants during the study period to treat depression and anxiety disorders. In addition, clinical guidelines were published that supported the use of these medications for a variety of conditions.

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