The prescription of psychotropic drugs (those that act on one’s mental state) has gone off the rails. Drugs like anti-depressants are often prescribed for depression and anxiety by doctors with little to no mental health training; they’re also prescribed to treat chronic pain, an application not supported by evidence and carrying a wide range of risks.
This information is not terribly new; for years reputable sources like the CDC have been tracking prescription trends and speaking out against flagrant over-prescription. Yet the trend is still on the rise. It is currently estimated that 1 in 5 adults in the U.S. uses psychotropic medication. According to a study of over 50,000 surveys, the percentage of people taking antidepressants has increased, but users being treated with psychotherapy declined from 31.5% in 1996 to 19.87% in 2005. More on this can be found at archpsyc.jamanetwork.com.
On top of risks, another concern is that these drugs are being prescribed when they might not be needed. It’s not uncommon to hear of patients being offered antidepressant prescriptions upon their first doctor’s visit, whether or not they report feeling depressed. The author of this post was encouraged to take free samples of anti-depressants for mentioning fatigue as one of her symptoms at her first meeting with one doctor at the age of eighteen. “Fatigue is one of the top symptoms of depression,” the doctor said. This particularly insistent doctor failed to mention that fatigue is a top symptom of almost every ailment. Fortunately, the patient refused and went on to find the real cause of her symptoms, which was not depression.
Antidepressants get a lot of play outside the mental health field. They’re often prescribed to patients with chronic pain; the brain chemical alterations they cause can theoretically alter our sensation of pain. According to a Cochrane Library study that assessed ten trials, solid evidence supporting the use of antidepressants for chronic back pain is lacking. Their study found conflicting results for the effectiveness of antidepressants in reducing pain levels and also a lack of evidence for their efficacy in treating depression itself in those with corresponding chronic pain. See onlinelibrary.wiley.com for more details on the study.
Doctors have a lot of incentive to prescribe medication. Psychiatrists and physicians can make more money from reimbursements for prescriptions than from performing other forms of treatment. The pharmaceutical industry is also big on advertising. Medication is presented to the public as a typical course of treatment, one that eliminates problems with the simple swallow of a pill.
Depression and chronic pain management don’t necessarily require drug treatment. The shift in focus from symptom masking to safe and natural treatment of causes must begin in the patient’s consciousness.