Concerns over rising psychotropic drug use

Psychotropic medication use has risen dramatically over the last 12 years, despite growing concerns over pharmaceutical industry influence and their questionable contribution to improving the mental health of Australians, new research suggests. The first comprehensive analysis of long-term trends in Australian psychotropic prescribing since 1987 found a “striking” increase of 58% from 2000 to 2011.

Against the backdrop of increased support for non-pharmacological interventions to treat depression and anxiety, coupled with the advent of few, if any, breakthroughs in pharmacological ‘quick fixes’, “one might expect a more cautious approach to psychotropic prescribing”, said the researchers from the University of Sydney School of Psychology. But the results suggest “a rapidly growing utilisation of medications to tackle mental health problems”.

The rising trend was driven by a major increase in antidepressants, atypical antipsychotics and ADHD medications, according to the study published in the Australian New Zealand Journal of Psychiatry.

Antidepressants unseated benzodiazepines as the most frequently dispensed psychotropic drug, commanding a 95% rise in defined daily dose per 1,000 people per day between 2000 and 2011, accounting for 67% of the total psychotropic daily doses in 2011.

The data represents a “profound shift” in psychotropic dispensing, considering benzodiazepines constituted 59% of the surveyed prescriptions between 1977 and 1984, the authors said.

The increase in antidepressants was likely due to an increased public awareness of depression, improved side-effect and safety information for the newer SSRI, SNRI and NaSSA classes and an increased use of antidepressants to treat anxiety.

But despite these “rational explanations” the poor or inflated efficacy of these drugs, as well as theover-diagnosis of depression needed to be addressed, the authors said.

“The increasing reliance on psychotropic medications ... generated considerable controversy, especially given current concerns about the influence of the pharmaceutical industry on treatment practices and the absence of any improvement in the mental health of Australians, they concluded.

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ANZJP, January 2013