Over Prescription of Antidepressants in America
Over the years, physicians and
psychiatrists have become more aware of many different diseases and their
effects on the human mind and body. Along with these new discoveries have come
many new drugs that claim to make the symptoms of a disease become less
prominent in a patients everyday life and hopefully, eventually rid them of
their symptoms and mental illness. Antidepressants are one of these new drugs.
Antidepressants fight against the symptoms of depression which is becoming one
of the most prominently diagnosed mental illnesses.
Depression is defined as a, “a
medical illness that causes a persistent feeling of sadness and loss of
interest.” Along with this definition there are symptoms such as difficulty
concentrating, fatigue, feeling of guilt, worthlessness, hopelessness, and
being irritable. Many people of different ages and nationalities suffer from depression.
People in their mid-30s are more likely to develop depression than any other
age group. Caucasian middle and upper classes are also more likely to be taking
antidepressants because they are able to afford a doctor’s visit as well as the
prescription cost. Most of the lower class are unable to afford the medication
and fees that come with going to the doctors, or urgent care facilities, thus
making the upper and middle classes the biggest consumers of antidepressants.
According to Centers for Disease Control and
Prevention (CDC), “An estimated 1 in 10 U.S. adults report depression.” The CDC
has estimated an increase in the use of antidepressants to nearly 400% from
1988 to 2011. This increase is due to more identifying symptoms of depression
that doctors did not know about until later, as well as prescribing
antidepressants for other mental illnesses as well not just for depression. The
increase in prescription of antidepressants has also made it the second most
prescribed drug in America, right after drugs to lower cholesterol National
Public Radio says in an article titled “Antidepressants Use Climbs, As Primary
Care Doctors Do the Prescribing.” The article then continues to say that an
astonishing “Seven percent of all visits to a primary care doctor now involve a
prescription for antidepressants.” Primary care physicians are not as qualified
to be prescribing long-term antidepressants as a psychiatrist is because they
are not as objective to the symptoms of severe depression compared to mild
depression. Studies have shown that when given a placebo, 10% of participants had
significantly lower symptoms of depression.
Many of the antidepressant drugs
that doctors prescribe are meant for only severely depressed patients, but they
are giving the medication to moderately depressed patients as well. This is
where the question, “Are doctors over prescribing antidepressants,” comes into
play. According to the CDC, many primary
care physicians are trying to avoid under prescribing the population. Under
prescribing means when you leave a majority of patients out of a certain
medication qualification. Many patients now days are self-assessing their
symptoms and since depression is a very common mental illness with a vast
spread of symptoms, patients are coming into medical offices demanding that
they be put on these medications and reassuring the doctor that they are really
depressed. This type of behavior is what
causes doctors to over prescribe antidepressant medication.
Another reason for the increase
in antidepressant prescriptions is the fact that doctors are prescribing it for
more than just depression. These medications can be ‘used’ to help with
anxiety, insomnia, and any of the other symptoms that a patient might be
having. I interviewed a friend of mine that had gone through a stage in her
life where she needed professional help for a drug addiction she was suffering
from. She said that the doctors and nurses at the rehabilitation facility she
was at, “gave out antidepressants like they were candy.” Now many of the people
in the facility with her were in fact depressed and needed help, but she
personally was not depressed and was prescribed antidepressants because she had
anxiety attacks. When she went home after being on this medication for two
months and under the watchful eye of the psychiatrists and physicians at the
rehabilitation facility, her mother noticed that she was acting very strange.
She started to cry and become very violent when a plate of cookies was gone.
She threw the plate across the room, making it shatter. As soon as her mom got
her under control, she called a different psychiatrist to set up a meeting
about switching her medication to something different than antidepressants
because she was not depressed and just needed medication when she was having anxiety
attacks which were happening often with the antidepressant medication she was
on. Thankfully now my friend just takes medication when she is having an
anxiety attack which is now very rare for her compared to when she was taking
antidepressants.
On the opposite side of the
argument, many doctors are claiming that they are over prescribing because of
the different diseases and illnesses that the antidepressant drugs are able to ‘help’.
According to a study performed by Queens College of the City University of New
York there are quite a few different medical conditions that antidepressants
can possibly better they include, but are not limited to anxiety, agitation,
obsessive compulsive disorders (OCD), bed-wetting, post-traumatic stress disorder
(PTSD). All of these are very different
illnesses but, seem to be controllable by the same medication. Since
antidepressants can be used for so many different conditions, the study
suggests that that is the reason for the spike in prescriptions filled over the
last 4 years.
To combat the opposition, with
the ability to cover such a wide range of illnesses, what are the symptoms,
side effects, and long term effects on these patients who are taking
antidepressants who are not depressed? In an online study of 856 participants,
researchers were looking for side effects of taking antidepressants and which
was the most common to least common symptoms. From the data collected, the most
common side effects was sexual dysfunction with 41.9% followed by fatigue with
36.8%. the least experienced symptom was excessive sweating with 20% of
participant selecting it from the list on the online test. These results were
taken from people who were using antidepressant medication without being
depressed. They had a wide variety of illnesses that they were taking the
medication for.
Some of the major concerns about
antidepressant are over prescription to patients who are not severely depressed
and will be hooked on the medication for the rest of their lives, as well as the
age ranges that are taking the medication. Teens and young adults have a higher
likely hood of having serious side effects that could deter them in their
everyday activities as well as make them even more depressed thus making them
suicidal. The FDA had put in place many new rules and regulations for
prescribing teens and young adults antidepressants because of a number of
suicides and also because the percentage of those patients taking the
medication compared to how many have or have thought about committing suicide
has escalated to a very uncomfortably high number. A recent study was held by
the American College of Neuropsychopharmacology or ACNP, looked at the data of
49 teenagers who had committed suicide and found that 24% had been prescribed
antidepressants. With that number so very close to one fourth of the sample
population, the FDA decided that they need to make harsher regulations on teens
medications and what antidepressants are approved for them since many of the
antidepressants are specialized for certain age groups.
With so many new medications
coming out for antidepressants, doctors need to really look at all of the
symptoms their patients have very closely to see if this patient is qualified
for an antidepressant before prescribing them. These medications are not
something to take lightly when you are being prescribed them. Doctors need to
be making sure that patients are going to check up with a psychiatrist to see
if they are actually making a difference or making the symptoms worse.
Antidepressants are meant to work for severe depression, that is what they
should be prescribed for.
Works Cited
"An Estimated 1 in 10 U.S. Adults Report
Depression." Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention, 31 Mar. 2011. Web. 08 Apr. 2013.
Hagell, Ann. "Increased Levels of Anxiety
and Depression as Teenage Experience Changes over Time." Nuffield
Foundation |. Nuffield Foundation, 14 Mar. 2012. Web. 08 Apr. 2013.
Kikuchi, Toshiaki, Takefumi Suzuki, Hiroyuki
Uchida, Kiochiro Watanabe, and Masaru Mimura. "Coping Strategies For
Antidepressant Side Effects: An Internet Survey."Journal of Affective Disorders 143.1-3 (2012): 89-94. Print.
Rutherford, Bret R., Joel R. Sneed, and
Steven P. "Does Differential Drop-Out Explain The Influence of Study
Design On Antidepressant Response?" Journal of Affective Disorders 140.1 (2012): 57-65. Print
Staff, Mayo Clinic. "Definition." Mayo Clinic. Mayo Foundation for Medical Education and
Research, 10 Feb. 2012. Web. 10 Apr. 2013.
Szalavitz, Maia, and Maia Szalavitz. "What
Does a 400% Increase in Antidepressant Use Really Mean?" Time.
Time, 20 Oct. 2011. Web. 08 Apr. 2013.
