Canadians using too many

One of Canada’s top psychiatrists says too many Canadians are treating life’s normal spells of misery the way they would handle something they dislike about their bodies: By asking a doctor to make their lives better.

That may explain why we take twice as many antidepressants as Italians do, and more than Germans or French, says Dr. Joel Paris, professor and past chair of the department of psychiatry at Montreal’s McGill University.

“We’re not always happy, and there are often good reasons for unhappiness,” Paris says. “But there’s this idea that we should all have high self-esteem, fantastic relationships and tremendous jobs.

“It’s like cosmetic psychopharmacology: If you don’t like the way you look, you go to a plastic surgeon and get it fixed. If you’re not happy enough, go to a doctor and go on antidepressants.”

Canadians rank among the highest users of antidepressants in the world: in 2011, the last year for which comparative figures are available, Canada reported the third highest level of consumption of antidepressants among 23 member nations surveyed by the Organization for Economic Cooperation and Development.

The OECD figures, contained in its recently released Health at a Glance report, show Canadians consumed 86 daily doses of antidepressants for every 1,000 people per day in 2011, more than the United Kingdom (71 doses per day), Spain (64) and Norway (58).

Canada was behind only Iceland (106 doses per 1,000 people per day) and Australia (89 doses) among the countries surveyed.

(The data are expressed as “defined daily doses,” which means the average daily maintenance dose for the condition for which the drug was prescribed.)

In Canada 42.6 million prescriptions for antidepressants were filled by retail drugstores in 2012, up from 32.2 million in 2008, according to figures provided to Postmedia News by prescription-drug tracking firm IMS Brogan.

Citalopram (sold under the brand name Celexa), venlafaxine, (Effexor) and the generic drug, trazodone, make up the three top-selling antidepressants in Canada.

Paris and others stress that antidepressants are essential in cases of severe, debilitating and life-threatening depression.

But the pills, including Prozac and its cousins that were held out to be miraculous when they hit the market in the late 1980s, are being swallowed by millions of Canadians every day, even while studies suggest that, in cases of mild depression, where “you’re still working, you’re still functioning,” Paris says, the drugs often don’t work, or they produce a temporary placebo effect, which doesn’t last.

“And then you get onto this thing, where you try another one, and you try a third one, and then you add some other type of drug entirely,” Paris says.

“It’s a whole treadmill of pharmacology people get caught up in.”.