Healthy Living: Antidepressant Use 

By- Dr. Anthony NgAntidepressant use has become increasingly prevalent and widespread. According to a recent report, it showed the rate of antidepressant use among Americans of all ages increased nearly 400 percent over the last two decades, and 11 percent of Americans aged 12 and older now take antidepressant drugs, according to a federal government report released Wednesday.Other data that provided evidence of the increased use of antidepressants including an analysis of 2005-2008 data from the U.S. National Health and Nutrition Examination Surveys which showed that antidepressants are the third most common prescription drug taken by Americans of all ages and the most frequently used by those aged 18 to 44. Additionally, of those patients with severe depression, about one-third takes antidepressant medication. More than 60 percent of Americans taking an antidepressant drug have taken it for two years or longer and nearly 14 percent have taken the medication for 10 years or more, according to the U.S. Centers for Disease Control and Prevention researchers. Another important finding is that less than one third of those taking multiple antidepressants have been seen by a mental health professional within the past year.Depression is one of the most common mental health illnesses that afflict a population. In the above study, the prevalence of depression was about 20%, roughly one in five Americans suffer from depression. Some seek treatment from mental health professionals, some from their primary care providers, while there are others who do not seek any treatment at all. Untreated depression can lead potentially to significant impairments in functioning, including work and school, quality of life and in some instances even suicide.Treatment for depression is available. The advent of safer antidepressant such as the well known Prozac, Zoloft and Paxil, all of which belong to the class of antidepressants called SSRI or Serotonergic Reuptake Inhibitors, has been a significant advance in the treatment of depression. These drugs are also used in other conditions such as anxiety disorders, post traumatic stress disorder and pain. As the above study showed, antidepressant use has skyrocketed in the past twenty years or so. Primary care providers have become very sophisticated and informed in the use of antidepressant. Antidepressants may be provided by a primary care provider as these providers are often more accessible and they can monitor antidepressant fairly well in most instances. However, there remain some patients with more severe depression and other psychiatric conditions that may benefit from additional treatment, such as psychotherapy, that many of the primary care providers are unable to provide as they may not have the time or the training to provide psychotherapy. As such, it is important that primary care providers work closely with mental health professionals and that patients are open to the team approach to manage their depression. This team may include a therapist and the primary care provider or a psychiatrist and a primary care provider. The psychiatrist can be helpful especially in collaborating with the primary care providers to choose the more appropriate antidepressants to help the patient. Most importantly, patients should have very open discussions with their doctors about the role of antidepressants, what are the potential side effects to look for, what are the target symptoms and what to do when their symptoms do not improve or worsen. In order to increase the likelihood of antidepressant treatment helping them, patients need to take an active role in managing their illness. SOURCE: U.S. Centers for Disease Control and Prevention, news release, Oct. 19, 2011: Tolu Olupona, M.D., assistant clinical professor, pediatrics and psychiatry, Mount Sinai Hospital Adolescent Health Center, New York CityShim RS, Baltrus P, Ye J, Rust G. Prevalence, treatment and control of depressive symptoms in the United States: Results from the National Health and Nutrition Examination Survey (NHANES), 2005 – 2008. Journal of American Board of Family Medicine. 2011:24:33-38.