Antidepressant Medication: Millions Prescribed Have No Psychiatric Diagnosis

Are you taking antidepressants for something like sleep problems or a sour mood?

Well according to a recent study in The Journal of Clinical Psychiatry, you may not be alone.

Researchers found that more than a quarter of Americans currently taking antidepressants haven't actually been diagnosed with the conditions that traditionally qualified one for a prescription, like depression or anxiety disorders.

The potential issue with all of this, Reuters Health reports, is that it means thousands of patients are being exposed to possible side effects, sans any proven health benefits. And where antidepressants are concerned, side effects do exist.

According to the Mayo Clinic, antidepressants can cause anything from nervousness, headache and dry mouth to insomnia, dizziness and erectile dysfunction.

The prescription of antidepressants has long been a hot-button issue, with some arguing that while popular, the drugs are not always helpful. Others believe that they are absolutely essential to treating depression and have called for the continued development of new, more effective drugs.

While the new study raises concerns about the antidepressant treatment in the U.S., experts speaking to Reuters Health cautioned against rushing to judgment.

"As far as overprescribing, I don't think you can say that it is occurring as a blanket statement," Jeffrey S. Harman, an expert in health services at the University of Florida in Gainesville, told Reuters.

"There are undoubtedly many people being prescribed antidepressants that may not be effective for them, but there are also millions of Americans suffering from depression who are not being prescribed antidepressants or are being prescribed them at a suboptimal dose."

Indeed, according to an article in the January issue of Archives of General Psychiatry, only 41 percent of Americans with any mental health disorder receive treatment, and only a fraction receive treatment that meets minimal standards of quality care. Of that group, approximately half receive care in the specialized, mental health sector, while half are treated by non-specialists, like primary care doctors. This matters because those who receive treatment in the specialty sector stand a much better chance of getting so-called "minimally adequate care" -- about four times better -- than those treated in primary care. But care in both settings needs improvement.

The Huffington Post's Medical Editor, Mental Health, Lloyd I. Sederer, M.D., says it's going to take a lot for the system to change for the better. He calls for more results-oriented, performance-based payment for doctors and hospitals, improved electronic records and beefed-up consumer education and advocacy. "That," Sederer says, "is how we can close the gap between what we know and what we do."

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Comments

[ianmcc]

04:07 PM on 03/23/2011

That's the problem with how insurance billing is now set up. The healthcare & pharma industries are linked in that they severely limit the number of mental health therapy sessions a patient is able to bill onto their insurance, all for in favor of prescribing meds for profit over the mental wellbeing of the patient who would be much better off having more months of therapy that can be billed onto their insurance to get the help they really need.

[Jeanne Ball]

09:31 PM on 03/14/2011

A recent study led by researchers at UCLA shows that over a 12-month period, depressive symptoms decreased by almost 50% among people practicing the Transcendental Meditation technique, compared to controls. Unlike drugs that merely mask the symptoms, the TM technique improves brain functioning, increases serotonin and reduces stress, it addresses many of the underlying imbalances that give rise to depression. The study was presented at the 31st Annual Meeting of the Society of Behavioral Medicine in Seattle, Washington April 9th, 2010.

[ianmcc]

04:09 PM on 03/23/2011

I've found sound therapy to be of benefit for my clients and with some of my depressed clients may give them a singing bowl for meditative purposes to enhance their practice of guided imagery techniques.

[Joseph Burgo PhD]

01:51 PM on 03/14/2011

What makes this phenomenon all the more troubling is that the true effects of these medications are much worse than we've been led to believe by the APA and the pharmaceutical industry. Other comments here have pointed to studies demonstrating that these meds are no more effective than a placebo, but that's only in the short-term. Beyond the initial 8 weeks, the medications WORSEN the long-term prognosis, leading to increased recurrences of depression, NEW episodes of bipolar illness and increased anxiety. Anyone interested should read Robert Whitaker's excellent study of this issue, THE ANATOMY OF AN EPIDEMIC.

Joseph Burgo, PhD
http://www.afterpsychotherapy.com

[Natalie Guerrier]

06:27 PM on 03/14/2011

Thanks for continuing to get the word out about Whitaker's work - it's time for the public to know the truth behind the incestuous relationship of the pharmaceuticals, APA, NIMH, and NAMI. The extent to which the scientific findings, the side effects, etc. have been covered up is not surprising given the billions at stake, not to mention the very future of psychiatry. Enough is enough.

Natalie Guerrier
Mental Health Advocate
www.rockpapershutup.com

[GodlessHeathen23]

11:08 AM on 03/18/2011

Joseph Burgo: Have you ever suffered from severe anxiety/depression? Have you ever been plagued with multiple panic attacks? Have you ever been so riddled with anxiety that you couldn't leave your house? Have you ever felt like you were losing your handle on reality? Have you ever felt so completely hopeless that you couldn't drag yourself out of bed in the morning?

I can't begin to explain to you what it's like to suffer from these issues. I have battled through them since I was a kid. I have literally tried everything to find relief and the ONLY thing that has made it possible for me to live a somewhat NORMAL life that people like you take for granted are anti-depressant drugs.

I'm glad you have the luxury to be so flippant about a matter that I can't afford to take for granted. If it weren't for these drugs, I don't think that I would be alive today.

[Joseph Burgo PhD]

11:40 AM on 03/18/2011

While I sympathize deeply with your pain, and the pain of clients I've treated with similar conditions, I suggest you read Whitaker's book before you accuse me of being "flippant".

Joseph Burgo PhD
http://www.afterpsychotherapy.com

[dc2nm]

11:56 AM on 03/13/2011

Like too many, I've struggled with depression and was even diagnosed with bi-polar. It is something that my entire family seemed to struggle with. However, over the past few years, my mother and all my aunts and uncles were diagnosed as hypothyroid. I was diagnosed with Hashimoto's (which is an autoimmune thyroid disease that eventually leads to hypothyroidism). Hypothyroid can appear as depression. Hashimotos can mimic bipolar. Myself and my family is being treated for their thyroid problems and the depression issues are gone.

Too often, doctors will give you a quick fix without really searching for a real medical problem.

[Natalie Guerrier]

06:21 PM on 03/14/2011

My mother had a similar experience to what you describe with you and your family. Interestingly, the anti-depressants themselves commonly cause thyroid problems...just one of many horrific side effects. So glad to hear you all found treatment that truly works!

Natalie Guerrier
Mental Health Advocate
www.rockpapershutup.com

[dc2nm]

07:00 PM on 03/14/2011

Since only 2 generations of my family are effected (my grandparent's are not), we are pretty sure it is environmental for us. We grew up in an industrial area that is now suing several factories for hexavelent chromium dumping....and I have since moved to an area that has high radioactivity levels (naturally occurring in the soil). I just wish there were more studies on the effect of heavy metal toxins on thyroid function.

[Widespread Panic]

07:07 PM on 02/28/2011

I've struggled with depression and anxiety my entire life. I've tried many anti-depressants and anti-anxiety meds, but every single last one of them either make me lethargic, drowsy, and/or nauseous. So I struggle to deal with it med free every day, which can be very difficult at times.

[Natalie Guerrier]

06:23 PM on 03/14/2011

The side effects you describe are incredibly common - unfortunately, these "wonder drugs" often do more harm than good, especially when used long-term. Have you ever heard of an alternative called Empower? I use it very effectively for bipolar symptoms with zero side effects, and know several people using it with great success for unipolar depression as well.

Natalie Guerrier
Mental Health Advocate
www.rockpapershutup.com

[Paige Hale]

04:00 PM on 02/16/2011

I can't believe how many people and unknowingly supporting big pharma. Big pharma doesn't care if someone taking their pills doesn't have the disorder. They want as many people on them as possible. They support TeenScreen, a program that screens kids for mental disorder without parental consent, then forcibly medicates them, even though it comes up with more false positives than real diagnosises. Same kind of legislation for expecting mothers. They want them screened and medicated. This would infuse their fetuses brain with the mind-altering drugs during developement, making them chemically dependent for the rest of their life. This is a conspiracy none of you apparentlycare about. Pills, ahoy!

[Blagica Gavriloska]

02:57 PM on 02/12/2011

then what vill have to take if ve arent satisfaction on life and feel sad an have a lot of problems

[rtgmath]

02:07 PM on 02/10/2011

Depression is a complex condition. It may be a "natural" part of aging. Certainly before the label was used, depression was still a common affliction. Authors like Edgar Allen Poe were afflicted by it. It used to be common among older people. And of course, people tended to die a lot younger. As medical care has improved, conditions like depression are much more visible.

Socially, people are expected to be at the "top of their game" a lot longer than in the past. Life is much more complex, expectations in the workplace are constantly changing and becoming more rigorous. Competition for fewer jobs means that employment is not a sure thing -- and the threat of sudden unemployment is a constant terror to many. Of course, with the prospects of social safety nets being dismantled, the stress levels continue to rise.

America's change from a confident producer nation to a stressful consumer nation has produced circumstances where anti-anxiety medications are essential to many. The problem is not so much over-medication, it is that the human body and mind are not set up to cope with such a wide variety of stresses from all directions. The state of constant alertness and anticipation is not natural or healthy - it wastes physical resources. True emergencies are handled less efficiently because all of life is lived on "emergency" settings.

Since modern life isn't going to demand less of us, medications to compensate are going to continue to be in demand.

[freewilled]

06:10 AM on 02/11/2011

Your comment is insightful and right on the mark!
I agree with your view completely. Symptoms of manic-depression has haunted me most of my life. Without the benefits of anti-depressants, some other psychotropic medications and counseling, I don't know that I would be alive today.

Thanks :)

[FoxIslander]

11:30 PM on 02/09/2011

My wife works at a dental office. New patients must fill out a medical history form. She says that 75% of women and 50% of men seeking treatment at her office are on an anti-depressant. Sounds like extreme over-prescribing to me. Follow the money. $$$$

[Cyrus Trance]

03:33 AM on 02/10/2011

Sounds like a lot of depression and anxiety to me.

[freewilled]

06:44 AM on 02/11/2011

So your saying that your wife has gone through 100% of the patient's charts at her employer's dental practice to come up with her statistics of 75% of women and 50% of men are taking anti-depressants? And then she is coming home and sharing this information with you? And then you think it is appropriate to post (peoples private health information) on a blog? And yes the medications you are on is protected health information. Perhaps your wife forgot about the HIPPA law. HIPPA protects a patient's personal medical information. She is legally and ethically bound not to disclose patient medical information with anyone other than within that dental office, unless specifically authorized by the patient, in writing. I am thinking that your wife didn't get the patients and/or her employer's permission to disclose her "statistics" to you.
Your statistics are just your wife's speculation. Nothing else.
As far as follow the $$$$- how about looking at what the average cost of dental procedures cost-revenue that her employer is bringing in ( from patients) = her paycheck. So the people she is being snide to and disclosing private medical information about are the ones who make her job and lively hood possible. Talk about biting the hand that feeds you.! As a licensed health care provider, I don't really care what medications your on, I am there to take care of you and keep your information private.

[FoxIslander]

03:41 PM on 02/11/2011

Do you see a single persons personal medical history discussed in my post? Did i say she went thru 100% of the reports? It is speculation...she works at a dental office and is well aware of HIPPA regulations.
Im surprised your a licensed health care provider...you seem unable to read.

[jrsyboy923]

07:46 PM on 02/09/2011

hi ive been on elevil to treat nerve damage from diabetes ive been on this for 13 years and the funny thing is a side effect you crave sugar

[commonsense333]

12:05 PM on 02/09/2011

I was fine, until the Army docs decided to put me on Lexapro. I had never had an anxiety/panic attack in my life, I simply had a small case of social anxiety. Once I started taking the Lexapro, that's when the snit hit the fan. I dropped it cold turkey, and had withdrawals for a month. A few months later, anxiety attacks started. Tried Zoloft, had 8 months of withdrawals from it, and I am not joking. Now on Celexa, and slowly weening myself off it, as I hate taking chemicals. These medications do have side effects, they do have horrible withdrawals, and they should be illegal. How can a medicine that can cause people to commit suicide be legal, while marijuana is illegal? What's worse, wanting to scream and chop your head off because you can't stand it any longer, or laughing your buns off at silly things and enjoying yourself? Hmm. Tough question isn't it? I hate the laws in this country, they are so backwards.

[sychodelix]

02:49 AM on 02/09/2011

I've been on Prozac and Paxil before and they were pretty much ineffective. Newer medications like Effexor tend to be vastly superior. The only issue is, if you ever have to stop taking it, it has withdrawal symptoms much more severe than even hardcore illegal drugs.

Some doctors hand antidepressants out like candy, and unless you REALLY need them, you are probably better off without them. Then again, if you have major depressive disorder without any sort of mania, you may not have any choice but to take them. Unlike what many on here are saying, you cannot always just snap out of it, and severe depression is crippling and live altering.

[GodlessHeathen23]

10:14 PM on 02/09/2011

I decided to try going off of my Effexor XR after being on it for about 6 years for severe anxiety/depression. I wanted to see if I could live life without it (even though it was working well) since I was living a 'healthy' lifestyle of plenty of exercise and good diet, etc. I was dreading the withdrawal symptoms I kept hearing about, but my doctor made it easy by giving me two weeks worth of Prozac to take while halfing my doses of Effexor, then quitting all at the end of the two weeks. I felt a bit off for about a month total, but nothing that was really all that bothersome. The violent withdrawal never happened.

Going off of the drugs, however, was a bad idea. About six months after being off of the drugs, all of my symptoms were back and I was in the midst of a breakdown. Needless to say, I went back on the drugs.

[sychodelix]

01:40 AM on 02/10/2011

Prozac tends to work well for weaning off of Effexor, but two weeks is not nearly long enough. Withdrawal symptoms from it can last for years, and you would likely have to stay on Prozac a long time. About six months to a year of Prozac would probably be the right rate to get over the withdrawal symptoms, and the Effexor itself has to be tapered off slowly for at least a month, maybe more, gradually reducing the dose a little at a time.

Even after all of that, there's still a chance that you could have problems later on, but not nearly as severely as being yanked off way too fast.

[Cyrus Trance]

03:40 AM on 02/10/2011

"it has withdrawal symptoms much more severe than even hardcore illegal drugs."

Nonsense, it's a mild withdrawal compared to narcotics specially the fat soluble ones.

[sychodelix]

02:58 AM on 02/11/2011

I've been in withdrawal from both, and you are completely and utterly wrong. Do some research on the withdrawal effects of Effexor and which can last for years and get back to me on that.

[b525]

06:48 PM on 02/08/2011

Something like 50% of Americans are moderately to severely vitamin D deficient from lack of sunlight. One of the main ill health affects of vitamin D deficiency is DEPRESSION.

African Americans are especially susceptible to severe vitamin D deficiency because their dark skin pigment, in the weak northern sunlight of America, does not allow their skin to absorb enough sunlight to synthesize vitamin D unless they deliberately expose themselves to large amounts of sun. The vitamin D deficiency rates in African Americans has been as high as 90% in some studies.

Other affects of severe vitamin D deficiency include heart disease, high blood pressure, diabetes, obesity, A.D.D. and other diseases, all higher in African American populations.

[MontanaMuleGal]

12:22 PM on 02/08/2011

If you have depression, you might consider that the reason is "endocrine disruption."

Many people, perhaps up to 80% in the US, are hypothyroid. Hypothyroidism is probably caused, in large part, by the 80,000+ chemicals in our environment.

Hypothyroidism may be treated with natural desiccated thyroid, an inexpensive medication which may cure many symptoms including fibromyalgia and chronic fatigue syndrome. (Note: Big Pharma does not like inexpensive medications.)

For more information, please check out the patient advocacy site:

Stop the Thyroid Madness.com. http://www.stopthethyroidmadness.com/

[dc2nm]

07:07 PM on 03/14/2011

Love that site. It saved the quality of my life after struggling for years.

I know that 2 generations of my family have it. I have hashi, my mother's generation has hypo and my grandparents have nothing. We strongly believe it is primarily environmental. The area we grew up in is highly industrial and several families are suing the factories for dumping hexavelent chromium in the Chesapeake Bay. My thyroid problem really went into full swing when I moved to Albuquerque, which has pretty high levels of uranium in the soil (it is naturally occurring here).

The technology that is supposed to make our lives easier is damaging the quality of life in ways we are just beginning to understand.

[herbalYODA]

12:14 PM on 02/08/2011

Most scientific studies show that the antidepressant drugs are no more effective than when using placebo. Why risk your health withe these over priced drugs when often orthomolecular approaches are more beneficial and more effective in correcting the problem.