"Many adults with major depressive disorder go for long periods of time without receiving treatment." At the same time, many people with mild depression are prescribed antidepressants even though they aren't likely to benefit from the drugs, he added.Ī growing body of research suggests that antidepressants aren't as effective as many people believe. "Antidepressants are overprescribed and underprescribed in the United States," Olfson says. Lower clinician reimbursement rates for psychotherapy and higher out-of-pocket costs to patients most likely contributed to the declining use of therapy, the study found.
By 2005, only one-fifth of patients did, according to a study of more than 50,000 medical surveys that was co-authored by Mark Olfson, MD, professor of clinical psychiatry at Columbia University ( Archives of General Psychiatry, 2009). In 1996, one-third of patients taking antidepressants also received therapy. And fewer of their patients receive psychotherapy than in the past. In the United States, almost four out of five prescriptions for psychotropic drugs are written by physicians who aren't psychiatrists ( Psychiatric Services, 2009). Most antidepressants are prescribed by primary-care physicians who may have limited training in treating mental health disorders. Antidepressants are the second most commonly prescribed drug in the United States, just after cholesterol-lowering drugs. Since the launch of Prozac, antidepressant use has quadrupled in the United States, and more than one in 10 Americans now takes antidepressants, according to the CDC. When Prozac (fluoxetine) was approved by the Food and Drug Administration (FDA) in 1987, it offered fewer side effects than other common antidepressants, leading to a burgeoning class of selective serotonin reuptake inhibitor antidepressants (SSRIs). APA also supports an integrated approach to health-care delivery in which primary-care and mental health providers work together to determine the best treatment plan for each patient. To help address those concerns, APA is developing clinical treatment guidelines that will help educate physicians, health insurers and the public about the best treatments available for common mental health disorders. Psychotropic drugs are valuable tools in treating many mental health disorders, but inappropriate prescribing can cause serious harm. The rapid growth of all three classes of drugs has alarmed some mental health professionals, who are concerned about the use of powerful antipsychotic drugs by elderly nursing home residents and the prescription of stimulants to children who may have been misdiagnosed with ADHD.
In 2010, Americans spent more than $16 billion on antipsychotics, $11 billion on antidepressants and $7 billion for drugs to treat attention-deficit hyperactivity disorder (ADHD). The use of psychotropic drugs by adult Americans increased 22 percent from 2001 to 2010, with one in five adults now taking at least one psychotropic medication, according to industry data. "If people knew more, I think they would be a little less likely to go down the medication path than the psychosocial treatment path." "I would say at least half the folks who are being treated with antidepressants aren't benefiting from the active pharmacological effects of the drugs themselves but from a placebo effect," says Steven Hollon, PhD, a psychology professor at Vanderbilt University who has conducted extensive research on the effectiveness of antidepressants. Many Americans visit their primary-care physicians and may walk away with a prescription for an antidepressant or other drugs without being aware of other evidence-based treatments - such as cognitive behavioral therapy - that might work better for them without the risk of side effects. Today, patients often receive psychotropic medications without being evaluated by a mental health professional, according to a study last year by the Centers for Disease Control and Prevention (CDC). Writing a prescription to treat a mental health disorder is easy, but it may not always be the safest or most effective route for patients, according to some recent studies and a growing chorus of voices concerned about the rapid rise in the prescription of psychotropic drugs.
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