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Antidepressants
Why are antidepressants
the most prescribed drug in the U.S.?
BY JANE MCGRATH
In
2007, the Centers for Disease Control and Prevention made an intriguing
announcement. Antidepressants were the most frequently prescribed drug,
overtaking the runner-up, high blood pressure medications, by five million
prescriptions.
The
study reported that doctors racked up 118 million prescriptions for
antidepressants in 2005 (out of a total of 2.4 billion prescriptions) [source: Cohen].
What
does this remarkable surge in antidepressant popularity say about how our
society now views depression?
Before
the 1980’s, seeing a psychiatrist was the preferred treatment for depression.
But
advances in technology have allowed new insights into the workings of the brain and
instigated a growing interest in antidepressants. Now, even primary care
physicians, not just psychiatrists, have become frequent prescribers [source: Lieberman].
Between
2005 and 2008, 11 percent of Americans 12 and up were taking antidepressants [source: CDC].
Antidepressants
have the power to change your moods, and they accomplish this by affecting the
amount of serotonin and norepinephrine in the brain.
Serotonin
and norepinephrine are neurotransmitters, which travel through neurons in the
brain.
Scientists
don't know a great deal about how these neurotransmitters affect your mood. But
they do know that when antidepressants alter how neurotransmitters travel, it
stabilizes your emotions.
So
what's the reason behind the rising number of antidepressant prescriptions?
One
reason is that, despite their name, antidepressants are not prescribed solely
for depression anymore. They are also used to treat chronic pain, anxiety,
panic disorder, obsessive compulsive disorder and even eating disorders.
Another
reason could be that more people are confiding in their doctors about their
struggles with depression.
When
you think of it that way, it seems like a positive trend in the United States --
patients are comfortable sharing the problem with doctors, and doctors are
recognizing and treating it.
But
the numbers also raise questions about misdiagnosis and overprescription.
Are
we too quick to throw a prescription at any old emotional problem? Read on to
learn more about this debate.
Do doctors overprescribe
antidepressant medications?
You can't really address the reasons
for antidepressant popularity without addressing the business of
antidepressants.
In 2004, brand-name antidepressant companies made more than
$14 billion [source: ResearchandMarkets].
These sales mean big business, and direct-to-consumer advertising (such
as television commercials) has helped fuel it. Studies indicate that this
kind of advertising has contributed to the growth in prescriptions [source: Kravitz].
When patients see commercials for antidepressants, such as
Zoloft, and think that it can help them, they go to their doctors and request
it.
Doctors are more likely to prescribe an antidepressant when
a patient specifically asks for it. Some believe doctors are usually too
anxious to diagnose someone with depression.
The symptoms for depression from the Diagnostic and
Statistical Manual of Mental Disorders (DSM-IV) include:
Depressed mood
Taking less pleasure in life
Changes in appetite
Changes in sleeping pattern
Restless habits
Lack of energy
Feeling worthless or guilty
Inability to concentrate
Suicidal thoughts [Source: Wise]
But even with these parameters, distinguishing severe
depression from natural periods of feeling "down" can be a murky
call. Professor Gordon Parker thinks doctors interpret the common blues as
clinical depression all too often [source: BBC News].
In a long-term study he conducted, he found that a great
majority of people could be diagnosed as depressed on the criteria that doctors
use. He took this to mean the criteria for depression is too loose.
It appears the combination of consumer advertising and
doctors' difficulty in definitively diagnosing clinical depression could have
contributed to the rise in antidepressant use.
Still, others support the increase in antidepressant use,
arguing that it is better to diagnose depression too often than too little.
If you are hesitant to take antidepressants or don't think
your condition is severe enough to warrant therapy, you have options.
Regular exercise, for instance, can dramatically relieve
depression.
In addition, maintaining a balanced, nutritious diet and
reducing the intake of stimulants, such as cigarettes and caffeine, can help as
well.
.
THE DOWNSIDE TO
ANTIDEPRESSANTS
The most common reason people quit
antidepressants is the negative side effects.
These include nausea, weight gain, loss of sexual appetite,
erectile dysfunction, fatigue, and sleeplessness, among other things [source: MayoClinic].
In some rare cases, antidepressants have contributed to
suicides of children and adolescents.
In 2004, the FDA set a requirement that antidepressant
containers come with a "black-box" warning indicating this risk [source: FDA].
Studies now reveal that suicidal thoughts might result from
antidepressants decreasing the user's levels of dopamine [source: Biotech
Business Week].
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