Antidepressants prescriptions

Bramble, D.J. (1995) Antidepressant prescription by British child psychiatrists practice and safety issues. J Am Acad Child Adolesc Psychiatry 34 327—331. 

Isacsson, G., Boethius, G., Bergman, U. Low kvel of antidepressant prescription for people who later commit suicide 15 years of experience from a population-based drug database in Sweden. Acta Psychiatr. Scand. 85, 444-448, 1992. 

Katz LY et al Effect of regulatory warnings on antidepressant prescription rates, use of health services and outcomes among children, adolescents and young adults. CMAJ 2008 178(8) 1005. [PMID 18390943]... 

Figure 8.1 Trends in antidepressant prescriptions in the United Kingdom (1991-2000)...

The FDA s recent black box warning could serve to initiate a natural public health experiment. The change in labeling may be accompanied by a reduction in antidepressant prescriptions, particularly for youth. 

Strong, C. (2007, August). Black box slows antidepressant prescriptions. NeuroPsychiatry,... 

Cheeta S, Schifano F, Oyefeso A, Webb L, Ghodse AH. Antidepressant-related deaths and antidepressant prescriptions in England and Wales, 1998-2000. Br J Psychiatry 2004 184 41-7. 

In the 1980s an entirely new class of antidepressant arrived with the SSRIs, firstly fluvoxamine immediately followed by fluoxetine (Prozac). Within 10 years, the SSRI class accounted for half of antidepressant prescriptions in the United Kingdom. Further developments in the evolution of the antidepressants have been novel compounds such as venlafaxine, reboxetine, nefazodone and mirtazapine, and a reversible monoamine oxidase inhibitor, moclobemide. 

I Continuous antidepressant prescription appears more effective than lithium prophylaxis. 

The previously mentioned survey indicates that a vast majority of depressed adolescents never receive treatment for their illness, yet the number of antidepressant prescriptions written for teens increases every year. A pediatric survey conducted in the years 1995 and 1999 found the number of adolescents prescribed Prozac-like drugs increased 78 percent. In the 7-12 age group, prescriptions increased 151 percent for kids age 6 and under it rose to a surprising 580 percent. For children under 18, the use of mood stabilizers other than lithium has increased 40-fold, or 4,000 percent, and... 

But is this rise in college antidepressant prescriptions really so alarming Surveys have shown that college students are under more stress than ever before. Peter Kramer, the author of Listening to Prozac, feels less wary about giving antidepressants to college students than he once was, stating... 

Bingefors KAL, Isacson DGL, von Knorring L> Smedby B (1995). Prescription drug and healthcare use among Swedish patients treated with antidepressants. Ann Pharmacother 2 y 566-72. 

Owing to increased awareness of the illness and the advent of newer and safer antidepressant medications, the past two decades have seen improvements in the screening, diagnosis, and treatment of MDD. The willingness of generalist practitioners to involve themselves in the identification and treatment of MDD is noteworthy. To that end, antidepressants have become some of the most commonly prescribed drugs, and they account for 10 of the top 100 prescription drugs dispensed in the United States.1 Despite recent increases in the treatment of MDD, inadequate treatment remains a serious concern.2... 

Some studies compare dietary supplements to sub-therapeutic dosages of prescription medicine. For example, St. John s wort is compared to some of the tricyclic antidepressants. However, the given doses of amitriptyline and imipramine were below the recommended antidepressant doses. 

Like most people, I used to think that antidepressants worked. As a clinical psychologist, I referred depressed psychotherapy clients to psychiatric colleagues for the prescription of medication, believing that it might help. Sometimes the antidepressant seemed to work sometimes it did not. When it did work, I assumed it was the active ingredient in the antidepressant that was helping my clients cope with their psychological condition. 

In a particularly dramatic case of placebo-induced side effects, doctors at a hospital in Jackson, Mississippi, treated a young man who came into the emergency room, said to the receptionist, Help me, I took all my pills and then collapsed to the floor, dropping an empty prescription container. His blood pressure was abnormally low, and he was treated with intravenous fluids, which brought it back to within a normal range. The prescription bottle bore a label indicating that the medication was part of a clinical trial of antidepressants. Further investigation revealed that he had... 

The risk of potentially serious side effects should be enough to preclude the prescription of antidepressants for their placebo benefit, but this is not the only hazard associated with these medications. On 19 July 2006 the FDA issued a public-health advisory warning that, when taken in conjunction with other drugs that can affect serotonin levels, antidepressants can induce a life-threatening disorder called the serotonin syndrome .5 The serotonin syndrome is caused by an excess of serotonin in a person s body. 

St John s wort is a yellow flowering plant that was first used medicinally by the ancient Greeks as a diuretic and a treatment for wounds and menstrual disorders. This herbal remedy is widely prescribed in Germany, where it has been studied extensively in clinical trials as a treatment for depression. In most countries, including the UK, it is available over the counter. In Ireland it is available only by prescription. Recently, a team of German scientists led by Klaus Linde at the University of Munich published a comprehensive review of 29 clinical trials of St John s wort, involving more than 5,000 depressed patients. They concluded that it is more effective than placebos and as effective as standard antidepressants in the treatment of major depression. 

Table 2.1 shows the major therapy classes in terms of sales and the number of prescriptions dispensed in the United States in 2003. The top three therapy classes are antidepressants, antihyperlipidemics, and antiulcerants. They account for 39% of sales in this list of 17 therapy classes. There are significant changes to the growth of some therapy classes within a single year. This is... 

Bupropion is an atypical antidepressant drug that is the only nonnicotine-based prescription medicine approved for smoking cessation by the FDA. Its mechanism of action is presumed to be mediated by its capacity to block neuronal reuptake of dopamine and/or norepinephrine (Fiore et al. 2000). Relative to other antidepressants, bupropion has a relatively high affinity for the dopamine transporter (Baldessarini 2001). There is also evidence that bupropion acts as a functional nicotine antagonist, suggesting another potential mechanism by which bupropion could reduce smoking rates (Slemmer et al. 2000). 

Antidepressants. The tricyclic antidepressant desipramine has shown some small success in reducing cocaine craving, but the results are not overly impressive, and desipramine has many well-documented side effects and is dangerous in overdose (see Chapter 3 for more information). Cocaine-abusing patients who are not highly motivated will usually not remain adherent to the desipramine prescription. We do not recommend desipramine for the nondepressed cocaine addict. 

Antihistamines. After alcohol, antihistamines are the most commonly self-administered sleep medications. Foremost among these is diphenhydramine (Benadryl), which is also available as a component in a variety of over-the-counter nighttime medications including Tylenol PM and Excedrin PM. Prescription antihistamines like hydroxyzine (Vistaril, Atarax) are also occasionally used to treat insomnia. Finally, it is the antihistamine effect of some antidepressants and anti-psychotics that contribute to their utility as sedative-hypnotics. 

Using a different set of statistical procedures, Kravitz et al. (2005) found that prescribing an antidepressant drug was 2.92 times more likely when a standardized patient presented with major depressive rather than adjustment disorder symptoms, and 8.50 and 10.3 times more likely when the patient made a brand-specihc or a general medication request, relative to no specific medication request, respectively. Physicians varied systematically in their propensity to prescribe an antidepressant, regardless of the type of patient presenting. But none of the standardized patients was systematically more or less likely than other patients to receive an antidepressant drug prescription. 

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