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Arch Gen Psychiatry. 2009 Aug;66(8):848-56. doi: 10.1001/archgenpsychiatry.2009.81.

National patterns in antidepressant medication treatment.

Author information

  • 1Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. mo49@columbia.edu

Abstract

CONTEXT:

Antidepressants have recently become the most commonly prescribed class of medications in the United States.

OBJECTIVE:

To compare sociodemographic and clinical patterns of antidepressant medication treatment in the United States between 1996 and 2005.

DESIGN:

Analysis of antidepressant use data from the 1996 (n = 18 993) and 2005 (n = 28 445) Medical Expenditure Panel Surveys.

SETTING:

Households in the United States.

PARTICIPANTS:

Respondents aged 6 years or older who reported receiving at least 1 antidepressant prescription during that calendar year.

MAIN OUTCOME MEASURES:

Rate of antidepressant use and adjusted rate ratios (ARRs) of year effect on rate of antidepressant use adjusted for age, sex, race/ethnicity, annual family income, self-perceived mental health, and insurance status.

RESULTS:

The rate of antidepressant treatment increased from 5.84% (95% confidence interval [CI], 5.47-6.23) in 1996 to 10.12% (9.58-10.69) in 2005 (ARR, 1.68; 95% CI, 1.55-1.81), or from 13.3 to 27.0 million persons. Significant increases in antidepressant use were evident across all sociodemographic groups examined, except African Americans (ARR, 1.13; 95% CI, 0.89-1.44), who had comparatively low rates of use in both years (1996, 3.61%; 2005, 4.51%). Although antidepressant treatment increased for Hispanics (ARR, 1.75; 95% CI, 1.60-1.90), it remained comparatively low (1996, 3.72%; 2005, 5.21%). Among antidepressant users, the percentage of patients treated for depression did not significantly change (1996, 26.25% vs 2005, 26.85%; ARR, 0.95; 95% CI, 0.83-1.07), although the percentage of patients receiving antipsychotic medications (5.46% vs 8.86%; ARR, 1.77; 95% CI, 1.31-2.38) increased and those undergoing psychotherapy declined (31.50% vs 19.87%; ARR, 0.65; 95% CI, 0.56-0.72).

CONCLUSIONS:

From 1996 to 2005, there was a marked and broad expansion in antidepressant treatment in the United States, with persisting low rates of treatment among racial/ethnic minorities. During this period, individuals treated with antidepressants became more likely to also receive treatment with antipsychotic medications and less likely to undergo psychotherapy.

Comment in

PMID:
19652124
[PubMed - indexed for MEDLINE]
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