depressantsIt is rare that someone comes to my psychiatric practice for the first time not currently taking an antidepressant or having taken one in the past. In discussions with my internal medicine colleagues, they frequently comment on the increased use of this class of medications in their patient populations. So, a frequent question is:  Are antidepressants being overprescribed?

There are several reasons given for the increased use of antidepressants. There are more medications available for use, they are typically well-tolerated, and there is generally less stigma of mental illness with a growing acceptance of drug treatment by the public. There has also been a significant increase in direct-to-consumer advertising for antidepressant drugs. Additionally, the indicated use for antidepressants has expanded beyond pure depressive illness.

There is also the suggestion that prevalence of major depression may be increasing in the general population, or at least people are more willing to disclose that they have depression.

So, are antidepressants overprescribed? A more accurate question is whether individuals with depressive symptoms are getting appropriate treatment. Clearly not every individual with depressive symptoms needs an antidepressant medication. It is concerning that the use of psychotherapy is diminishing. Psychotherapy can be a very effective treatment for depressive symptoms. Exercise can also be an effective treatment for depression, but persuading a sedentary depressed person to exercise is a tall order.