Antidepressant use on the rise
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.