Physicians in North America might be prescribing antidepressants for people showing no depression symptoms, said researchers at McGill University in Montreal. According to a new study, the drugs are also prescribed for insomnia, pain and anxiety disorders.
Use of antidepressant drugs in North America has risen within the last two decades. Researchers suggest that some physicians are indicating these medicines for off-label use. Depression is one the most common mental disorders in the United States.
After analyzing tendencies in prescription, researchers found that only 55 percent of antidepressant drugs were indicated for depression. Detailed results of the study were published Tuesday in the Journal of the American Medical Association.
Researchers analyzed data from an electronic medical record, used majorly by primary care physicians in Quebec, Canada. They took into account prescriptions written for adults between January 2006 and September 2015.
Monoamine oxidase inhibitors were excluded from the study. 158 physicians, wrote 101,759 antidepressant prescriptions for 19,735 patients, during the study period. 18.5 percent of antidepressants were indicated for anxiety disorders and 10 percent for insomnia.
“Physicians are prescribing in the dark”
These drugs were also recommended for off-label indications such as pain and panic disorders, which account for 6 and 4 percent of all prescriptions, respectively. “Physicians are prescribing in the dark,” said Robyn Tamblyn, senior author of the study and professor of epidemiology at McGill University in Montreal.
“The thing that’s of concern here is that when prescribing for conditions other than depression, often these are for indications such as fibromyalgia and migraine where it’s unknown whether the drug is going to be effective, because it’s never been studied,” said Tamblyn to Philly.com.
Patients may be also taking antidepressants for a migraine, vasomotor symptoms of menopause, attention-deficit/hyperactivity disorder, and digestive system disorders, said researchers in a press release issued Tuesday.
Other conditions listed included sexual dysfunction, premenstrual syndrome, post-traumatic stress disorder, urinary problems, and bulimia, said Philly.com. The U.S. Food & Drug Administration has not evaluated the use of antidepressants for these conditions.
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Antidepressant use in the United States has considerably increased since 1988
Eleven percent of all U.S. citizens aged 12 and over take antidepressant medication, said the Centers for Disease Control and Prevention (CDC). An estimated 60 percent of Americans taking these drugs, have taken it for two years or longer.
Between 2005 and 2008, antidepressants were “the third most common prescription drug” in the country. From 1988 to 2008, its use has increased nearly 400% among all ages, added the CDC.
“The findings indicate that the mere presence of an antidepressant prescription is a poor proxy for depression treatment, and they highlight the need to evaluate the evidence supporting off-label antidepressant use,” said McGill University researchers.
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Developed tradition vs scientific knowledge
Some physicians propose that antidepressants should not necessarily be called like that, said depression expert Dr. Peter Kramer to reporters at Philly. These drugs have an impact on the nervous system.
However, “it remains uncertain if they reverse depression or treat injuries against nerve cells”, said Kramer, a clinical professor emeritus of psychiatry and human behavior at Brown University. For instance, some physicians prescribe amitriptyline to treat chronic pain.
Study’s lead author, Jenna Wong, said that physicians may be prescribing antidepressants due to “developed tradition”, instead of “practical or scientific knowledge”. She suggests that there are well-known off-label uses of these drugs.
“It’s kind of like a culture among doctors. You see your colleague prescribing it, and then you would be more likely to,” said Wong.
Health regulators should conduct new clinical trials, to determine if antidepressants are effective at treating other conditions, besides depression, concluded the authors.
— JAMA (@JAMA_current) May 25, 2016
45.1 million Americans were affected by mental illness in 2015
Mental Illness refers to disorders that generally alter the mood, said the CDC. Lamar Alexander from the U.S. Senate Committee on Health has reported that just 40 percent of adults with mental illness in the nation have received a proper diagnosis.
Scientists have found a link between mental illness and increased risk of developing chronic diseases, such as cardiovascular disease, diabetes, obesity, asthma, epilepsy and cancer, said the Centers for Disease Control and Prevention.
Mental disorders are among the most costly health conditions in the country. They generated costs of $57.5 billion in 2006, said the American Psychological Association. During 2015, there were approximately 45.1 million Americans with any type of mental illness.
Bushnell: For men and women, depression and psychosocial stress increase risk for stroke by 30%. #CDCGrandRounds
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Depression is the most recurrent form of mental illness in the nation
Depression is one the most common mental disorders in the country, said the National Institute of Mental Health. 15.7 million Americans had at least a major depressive episode within 2014, according to nationwide polls.
6.7 percent of all adult population may have a depressive event every year. People from ages 15 to 44 are the most affected by depression, which is more prevalent in women than men, said the National Institute of Mental Health (NIMH).
Check out this video by the World Health Organization:
Source: McGill University Press Release