An­tide­pres­sant use on the rise

Taranaki Daily News - - National News - Kata­rina Wil­liams

The num­ber of Ki­wis be­ing given an­tide­pres­sants is con­tin­u­ing to in­crease, yet re­searchers ad­mit there is no ev­i­dence to sug­gest they are im­prov­ing men­tal health or re­duc­ing sui­cides.

An Otago Univer­sity study pub­lished in the New Zealand Med­i­cal Jour­nal to­day ex­am­ined pre­scrib­ing trends for an­tide­pres­sants be­tween 2008 and 2015. It found the high­est an­tide­pres­sant user group was Euro­pean women, par­tic­u­larly those aged 65 and over, which sur­prised Pro­fes­sor Roger Mul­der, one of the lead re­searchers.

‘‘I guess it’s be­cause they present with dis­tress more of­ten but if you look at the epi­demi­ol­ogy of de­pres­sion, they’re prob­a­bly not the most likely group to get se­vere, melan­cholic de­pres­sion, which is when you say an­tide­pres­sants should be used,’’ Mul­der said.

‘‘What we seem to be do­ing is pre­scrib­ing more and more, es­pe­cially for white fe­males, and we don’t have ev­i­dence thatt i’s re­sulted in a sig­nif­i­cant re­duc­tion in lev­els of com­mu­nity dis­tress,’’ Mul­der said. ‘‘If any­thing, lev­els of com­mu­nity dis­tress seem to be in­creas­ing and it ob­vi­ously hasn’t re­sulted in a de­crease in the rates of sui­cide.’’

While pre­scrip­tion num­bers in­creased dur­ing the re­search pe­riod, the rate of those in­creases was slow­ing, in keep­ing with pre­scrip­tion pat­terns in other like­minded coun­tries.

‘‘The fact that our com­mu­nity mea­sures of men­tal health aren’t get­ting bet­ter is not un­usual ei­ther. Aus­tralia and the United King­dom, the USA and Canada – there’s very sim­i­lar trends,’’ Mul­der said.

‘‘It would sug­gest that giv­ing peo­ple more and more an­tide­pres­sants may not be the best way to man­age what on earth is go­ing on, which no-one quite un­der­stands be­cause as a com­mu­nity we seem to be get­ting more and more dis­tressed.’’

Re­searchers have at­trib­uted the rise to a va­ri­ety of fac­tors, in­clud­ing im­proved recog­ni­tion of de­pres­sion, changes in pa­tient­doc­tor at­ti­tudes and a broad­en­ing range of con­di­tions treated with an­tide­pres­sants.

Mul­der, who was based at Otago Univer­sity’s Christchurch cam­pus, said the re­search raised ques­tions about the way pre­scrip­tions were be­ing used. With no ev­i­dence to sug­gest more an­tide­pres­sant pre­scrip­tions im­proved com­mu­nity men­tal health or re­duced sui­cide, the re­searchers sug­gested a change in tack. ‘‘An­tide­pres­sants have sig­nif­i­cant side-ef­fects and we have limited ev­i­dence for long-term ef­fi­cacy,’’ the study said.

‘‘Per­haps it is time to switch em­pha­sis from a ‘treat­ment gap’ to a ‘qual­ity gap’ so that an­tide­pres­sant use is tar­geted more op­ti­mally at those who are most likely to ben­e­fit.’’

Otago Univer­sity Pro­fes­sor Roger Mul­der says while an­tide­pres­sant pre­scrip­tions are con­tin­u­ing to in­crease, there hasn’t been an im­prove­ment in com­mu­nity men­tal health.

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