Doctors alarmed by antidepressant culture

Edited by Jill Wright, 26 November 2013

European doctors are leading the way in challenging the disturbing explosion in the prescription of antidepressants for patients who would be better treated with the "talking therapies" employed by psychologists.

Responding to a questionnaire by six leading European newspapers, including The Guardian, the vast majority of close to 100 doctors and psychiatrists from the UK, Germany, France, Italy, Luxembourg, Belgium and Spain, said that a "prescribing culture" had arisen in their countries because access to psychologists and other non-drug therapy was very poor.

Only a Dutch doctor, Ricardo Teijeiro, said that his country's system had established that drugs might not be appropriate for milder forms of depression, and as a consequence, Dutch family doctors rarely prescribed antidepressants.

Data from the OECD shows that in the Netherlands antidepressant usage has increased by less than 25 per cent since 2001, and has not increased at all in the past five years. In Germany, the UK and Spain, however, prescriptions have doubled since 2003.

The trend is similar in Australia, where prescriptions have increased from 45.4 doses per 1000 inhabitants per day in 2000 to 88.9 in 2011. 

It would be very helpful if Australian doctors join their European colleagues in addressing the problem. For that matter, Australian newspapers could learn a lot from the way The Guardian and other newspapers are calling attention to the issue.

The Guardian quotes Harvey Whiteford, Kratzmann professor of psychiatry and population health at the University of Queensland in another article. Whiteford said there was good evidence that only major depression was likely to respond to antidepressants, but only about 50 to 60 per cent of people suffering from the condition received any treatment.

A British consultant psychiatrist, Professor Tim Cantopher, says that antidepressants are widely overprescribed "to get rid of unhappiness" which is not what they are designed for. But real clinical depression does respond to medication. 

Here at Psychology Melbourne, we have previously written about initiatives taken bypsychologists in the US and the UK to challenge inappropriate prescribing, although in my view, in more severe cases, antidepressants are helpful. Our psychologists frequently work hand-in-hand with doctors whose patients would clearly benefit from medication.

The issue has resonated with many people following the decision by batsman Jonathan Trott to leave the Ashes series. A comment piece by Fairfax columnist Alan Stokes on "how depression causes brain freeze" attracted some particularly poignant comments from readers.

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