Non-psychiatrists' antidepressant prescriptions without psych diagnosis rise from 1996 to 2007
FRIDAY, Aug. 5 (HealthDay News) --The number of antidepressants prescribed by non-psychiatrist physicians to patients without a psychiatric disorder continues to rise, according to a study published in the August issue of Health Affairs.
Ramin Mojtabai, M.D., Ph.D., M.P.H., from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and Mark Olfson, M.D., M.P.H., from Columbia University in New York City, investigated the trends in antidepressant prescribing by non-psychiatrist physicians in office-based practice. Patients aged 18 years or older, who participated in the 1996 to 2007 U.S. Centers for Disease Control and Prevention's National Ambulatory Medical Care Surveys, were included in the analysis. Patients who received antidepressants with or without psychiatric diagnosis were compared with patients with neither a psychiatric diagnosis nor antidepressant prescription. Patient visits within individual practices were aggregated. Clinical and policy implications of the observed patterns and trends were discussed.
The investigators found that the proportion of doctor visits that resulted in antidepressants being prescribed to patients without a psychiatric disorder increased from 59.5 to 72.7 percent between 1996 and 2007, and from 30 to 55.4 percent on aggregate analysis. There was only a slight increase in antidepressants prescribed with a psychiatric diagnosis during this period.
"To the extent that antidepressants are being prescribed for uses not supported by clinical evidence, there may be a need to improve providers' prescribing practices, revamp drug formularies, or vigorously pursue implementation of broad reforms of the health care system that will increase communication between primary care providers and mental health specialists," the authors write.
One of the study authors disclosed financial ties with Eli Lilly and Company.
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