Paul Okami asked, "Can anyone point me in the direction of data, graphs or charts of trends in the extent of antidepressant use in the US over the past two decades?"
>From the National Center for Health Statistics. "Health, United States, 2007 with Chartbook on Trends in the Health of Americans" (http://www.cdc.gov/nchs/data/hus/hus07.pdf ) says this on page 106 in pdf pages (page 88 in document pages): Antidepressant Drugs: Adults Non-Hispanic white women are more likely to have used antidepressant drugs in the past month than non- Hispanic black women or women of Mexican origin. Depression and other forms of mental illness are critical public health issues in America today. In 2001-2002, an estimated 16% of noninstitutionalized adults had a major depressive disorder at some point in their lifetime, with 7% having had a major depressive episode during the 12 months prior to interview (1). The detrimental effects of depressive symptoms on quality of life and daily functioning have been estimated to equal or exceed those of heart disease and exceed those of diabetes, arthritis, and gastrointestinal disorders (2,3). Access to both accurate diagnosis and appropriate treatment of depression is necessary to combat this prevalent and debilitating disease. Prescriptions for antidepressants have been rising, associated with the introduction in 1988 of a new class of drugs known as selective serotonin reuptake inhibitors (SSRIs) (4). Current SSRIs include the brand names CelexaT, LexaproT, LuvoxT, PaxilT, ProzacT, and ZoloftT. In addition to their use as antidepressants, SSRIs are approved and marketed for the treatment of other mental disorders including obsessive compulsive disorder, panic disorder, anxiety disorders, and premenstrual dysphoric disorder. The substantial increase in prescriptions for antidepressants also suggests widespread ''off-label'' (other than FDA-approved uses) use for subsyndromal mental health conditions and a variety of physical disorders (5,6). Between 1988-1994 and 1999-2002 the percentage of adults in the civilian noninstitutionalized population who reported using an antidepressant drug during the past month more than tripled, increasing from 2.5% to 8.0% (age-adjusted; data table for Figure 36, Technical Notes). Use among women rose from 3.3% to 10.6% and use among men from 1.6% to 5.2%. In both time periods, antidepressant use by women was about twice that of men. In 1999-2002, the percentage of non-Hispanic white adults who reported the use of antidepressants was more than double that reported by non-Hispanic black and Mexican adults. Nearly 13% of non-Hispanic white women reported use of antidepressants in the past month, compared with about 5% of non-Hispanic black and Mexican women. In the same time period, 6% of non-Hispanic white men reported antidepressant drug use in the past month, compared with about 3% of non-Hispanic black men and less than 2% of men of Mexican origin. Disparities in the diagnosis of depression of black and Hispanic patients compared to white patients may have narrowed in recent years. However, racial or ethnic disparities in the treatment-including prescriptions for antidepressant drugs-of depression once diagnosed persist (7). Black and Hispanic patients who have been diagnosed with depression are less likely to obtain counseling and drug therapy to treat their depression than are white patients. Factors contributing to this disparity may include a belief by more African American and Hispanic persons than white persons that antidepressant therapy is unacceptable or ineffective, a preference for other types of therapy, or financial and insurance barriers to obtaining treatment (7,8). References 1. Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, et al. The epidemiology of major depressive disorder: Results from the National Comorbidity Survey Replication (NCS-R). JAMA 2003;289(23):3095-105. 2. Wells KB, Stewart A, Hays RD, Burnam MA, Rogers W, Daniels M, et al. The functioning and well-being of depressed patients: Results from the Medical Outcomes Study. JAMA 1989;262(7):914-9. 3. Burvill PW. Recent progress in the epidemiology of major depression. Epidemiol Rev 1995;17(1):21-31. 4. Pincus HA, Tanielian TL, Marcus SC, Olfson M, Zarin DA, Thompson J, et al. Prescribing trends in psychotropic medications: Primary care, psychiatry, and other medical specialties. JAMA 1998;279(7):526-31. 5. Foote SM, Etheredge L. Increasing use of new prescription drugs: A case study. Health Aff 2000;19(4):165-70. 6. Stone KJ, Viera AJ, Parman CL. Off-label applications for SSRIs. Am Fam Physician 2003;68(3):498-504. 7. Miranda J, Cooper LA. Disparities in care for depression among primary care patients. J Gen Intern Med 2004;19(2):120-6. 8. Schraufnagel TJ, Wagner AW, Miranda J, Roy-Byrne PP. Treating minority patients with depression and anxiety: What does the evidence tell us? Gen Hosp Psychiatry 2006 Jan-Feb;28(1):27-36. -- Sue Frantz Highline Community College Psychology Des Moines, WA 206.878.3710 x3404 [EMAIL PROTECTED] http://flightline.highline.edu/sfrantz/ -- APA Division 2: Society for the Teaching of Psychology http://teachpsych.org/ Office of Teaching Resources in Psychology Associate Director Project Syllabus http://teachpsych.org/otrp/syllabi/syllabi.php --- To make changes to your subscription contact: Bill Southerly ([EMAIL PROTECTED])
