The Dark Cloud Over Growing Antidepressant Prescriptions


Does the market have you thinking about getting a little pharmacological help to ease your jitters and lift your mood? Getting a prescription for Prozac is easier than you think. In fact, you can skip the appointment with a psychiatrist altogether.

A study released last week in Health Affairs journal found a growing trend of doctors who aren't psychiatrists offering antidepressants to patients. The meds often get prescribed without any psychiatric diagnosis, simply to boost someone's mood, relieve mild anxiety, or improve sleep. Worse yet, there's no evidence these drugs actually help such patients.

All these questionable prescriptions helped make this class of drugs one of the most commonly prescribed in the U.S. In 2010, according to IMS Health data, antidepressants spending grew to $11.6 billion. The class was the second most prescribed after cholesterol regulators and heart meds, with nearly 254 million prescriptions.

It's No Secret Who's Really Smiling

The growth in antidepressant use brings a smile to at least one group of people: Big Pharma.

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While Eli Lilly's (LLY) Prozac has long lost its patent protection, U.S. Cymbalta sales for 2010 grew 9% to $2.8 billion, topping the $758 million mark in the most recent second quarter. Bristol-Myers Squibb's (BMY) Abilify U.S. sales grew by 5% in the recent quarter, to 517 million. AstraZeneca's (AZN) second-quarter U.S. sales of Seroquel XR grew 14% to $205 million. (Both Seroquel XR and Abilify are atypical antipsychotics approved by the FDA as adjunct treatments for depression that doesn't respond to a selective serotonin re-uptake inhibitor like Prozac or Zoloft alone.)

The study made no mention of any illegal marketing practices by pharmaceuticals that may have contributed to this trend, although such allegations regarding off-label marketing are certainly not foreign to AstraZeneca or Eli Lilly, among many others.

However, the study said that direct-to-consumer advertising could be causing patients to request the drugs. The U.S. and New Zealand are the only countries that allow advertising for prescription medications.

Do We Have a Drug Problem?

The researchers are concerned that this growing trend of non-psychiatrists prescribing antidepressants could mean that the drugs get prescribed inappropriately. They worry that patients who haven't been properly diagnosed are not receiving the best care they need. The study suggests starting by educating physicians on mental disorders, the drugs, and their appropriate use.

The researchers also encourage patients to ask questions -- lots of them, including questions about the diagnoses, the side effects, possible alternative treatments, and whether antidepressants are the right treatment for their problems in the first place.

Motley Fool contributor Melly Alazraki does not own shares in any of the companies mentioned.

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