Study: 50 Percent Of US Anti-Depressant Use Not Tied To An Identifiable Diagnosis

You read that headline right despite its clunkiness. In a study presented at the Canadian Psychiatric Association annual meeting yesterday, University of Winnipeg researchers asserted that more than 50 percent of Americans surveyed who took an anti-depressant did so "without possessing any indication for such treatment, according to accepted medical guidelines," said one of the researchers.

Before I go further, let me offer some cautions. This study has not been published yet (given its conclusions, I assume it will be), so it has not stood up to formal juried academic peer review, aside from whatever responses the authors got at the meeting. I don't want to conclude too much from this study until it's been published, but the fact that it cleared the various hurdles, including some form of peer review, to be presented at an academic conference gives me some confidence that the study is relatively kosher. Second, the study is based on surveys which can be somewhat unreliable (about 15,000 people were surveyed). Third, the one press account I read didn't give too much detail on what diagnostic criteria people taking anti-depressants weren't clearing hurdles for--depression? dysthymia? bipolar? anxiety? OCD? Fourth, only the barest of data is available to me at this point.

All of that said, I've previously documented on this site the crisis of overdiagnosis, or misdiagnosis, of bipolar disorder in America. Apparently, there are problems with other diagnoses as well, if I understand the implications of this study correctly. Perhaps that is because 80 percent of anti-depressant prescriptions written in the US are by non-psychiatrists (I have a friend whose cardiologist gave her anti-depressants) and your friendly neighborhood PCP isn't exactly a walking DSM. Certainly, a study like this makes you raise your eyebrows when you consider that 30 million Americans take anti-depressants and more than 230 million anti-depressants Rxs were written in 2007. If 50 percent or more of that use is somewhat baseless, then why exactly are 30 million people taking anti-depressants?

Especially when, as I noted yesterday, there is now evidence that the placebo effect is much larger and much longer lasting than was previously thought.

I'm not offering any of this information as an attempt to scare anyone off their meds or to press them to challenge their diagnoses. I'm certainly not saying depression isn't real or serious (I know too well how real and serious it can be). I'm just using it to offer some skepticism about where we are at in our culture as regards the use of anti-depressants. Like our nation's politics, it's all very mixed up out there.

(Thanks to Joe for passing along the study.)