Psych Drug Use Skyrockets Beyond Belief

A report just released by the Centers for Disease Control and Prevention (CDC) suggests that antidepressant use in the U.S. is soaring into the stratosphere. The investigators analyzed data from a survey of roughly 12,000 Americans between 2005 and 2008. Compared to an earlier survey (1988 to 1994), use of antidepressants “increased nearly 400%.” The key finding: “Eleven percent of Americans aged 12 years and over take antidepressant medication.”
We’re talking about drugs such as:
• bupropion (Wellbutrin)
• citalopram (Celexa)
• desvenlafaxine (Pristiq)
• duloxetine (Cymbalta)
• escitalopram (Lexapro)
• fluoxetine (Prozac)
• paroxetine (Paxil)
• sertraline (Zoloft)
• venlafaxine (Effexor)
According to our own calculations, roughly 160 million antidepressant prescriptions are dispensed each year. Here’s the kicker. The majority of those prescriptions are for mild to moderate depression. That’s despite the fact that the FDA has not approved such drugs for mild to moderate depression. The reason there is no approval is because the clinical trials have not proven that such drugs work for this indication. The FDA has approved the use of antidepressants for “major depressive disorder.” Yet only about one third of the prescriptions dispensed for antidepressants are for major depression.
What’s going on? Many prescribers, and that includes nurse practitioners, family practice physicians and internists, may not realize that the FDA has not approved antidepressants for mild to moderate depression. They may not be aware of the scientific literature that has demonstrated little to no benefit for such patients. One meta-analysis of well-conducted clinical trials concluded: “True drug effects (an advantage of ADM [antidepressant medications] over placebo) were nonexistent to negligible among depressed patients with mild, moderate, and even severe baseline symptoms.” JAMA2010; 303:47-53.
The CDC report notes that, “Less than one-third of persons taking a single antidepressant have seen a mental health professional in the past year.” That suggests that most patients are getting their prescriptions from someone who is not all that knowledgeable about the benefits and risks of such medications and may not be qualified to provide psychological counseling or recommend non-drug approaches to dealing with depression.
We want to acknowledge that some people get great benefit from this class of medication. For such individuals these drugs are life savers. For that we are most grateful. But many others get little benefit and may suffer from a range of side effects such as:
• Headache
• Nausea
• Dizziness
• Sexual dysfunction
• Diarrhea
• Anxiety
• Insomnia
• Drowsiness
Stopping antidepressants suddenly can lead to other symptoms such as:

• Dizziness
• Headache
• Nausea
• Nervousness
• Insomnia
• Sweating
• Shakiness
• Visual disturbances
• Weakness
• Difficulty concentrating
• Electric shock-like sensations
• Head-in-a-blender sensations
Most prescribers do not warn people adequately about how to stop such medications. That is in part because neither the FDA nor the drug companies nor the National Institute of Mental Health have issued any practical guidelines to assist clinicians in phasing patients off such drugs.
Bottom line: The CDC report suggests that antidepressants are frequently taken for mild to moderate depression, for which the evidence of effectiveness is marginal at best. People who have depression may want to listen to our interview with Stephen Ilardi, PhD, who offers six steps to help you beat depression without drugs. You may also find our guide, Dealing with Depression, of interest.