With more than 1 in 6 Australians (17.2% of the Australian population) receiving a mental health-related prescription in 2019–20, new findings showing that the long-term use of antidepressants resulted in no better physical or mental health should be of serious concern.
Especially when 72.1% of the 40.7 million mental health-related prescriptions filled nationally during this period were for antidepressants, with 82.7% of mental health medication prescribed by GPs rather than specific mental health specialists.
While past studies have shown the efficacy of antidepressant medications for the treatment of depression disorder, these medications’ effect on patients’ overall well-being and HRQoL remains controversial.
The new research, based on US data and published this week in the journal PLOS ONE by Saudi Arabia’s King Saud University, demonstrated that over time, “using antidepressants was not associated with significantly better health-related quality of life for people with depression when compared to individuals who do not take the drugs to treat their condition.”
Lead author, Omar Almohammed, explained that the use of antidepressants was still associated with some improvement on the mental component of health-related quality of life.
“However, when this positive change was compared to the change in the group of people who were diagnosed with depressive disorder but did not take antidepressants, there was no statistically significant association of antidepressants with either the physical or mental component.”
In other words, the change in quality of life seen among those on antidepressants over two years was not significantly different from that seen among those not taking the drugs.
The researchers used information from the 2005-2015 United States’ Medical Expenditures Panel Survey (MEPS), a large longitudinal study that tracks American health services, comprising all noninstitutionalized adults who had a documented case of depression during their first year of follow-up appointments.
Over the duration of the study, there were some 17.5 million adult patients diagnosed with depression each year (currently 21 million), and 57.6% of these received treatment with antidepressant medications.
Compared to Australia, where approximately one million people are diagnosed annually (some 6% of the population), the US has a higher rate of depression among adults at 9.5% but only issued 70.9 million prescriptions for antidepressants, or 216 scripts per 1000 people.
Australia’s 29.34 million scripts were the equivalent of 1,142 antidepressant prescriptions per 1,000.
The study was not able to separately analyse any subtypes or varying severities of depression and the authors note that future studies should investigate the use of non-pharmacological depression interventions used in combination with antidepressants.
“Although we still need our patients with depression to continue using their antidepressant medications, long-term studies evaluating the actual impact for pharmacological and non-pharmacological interventions on these patients’ quality of life is needed,” Mr Almohammed states.
“With that being said, the role of cognitive and behavioural interventions on the long term-management of depression needs to be further evaluated in an effort to improve the ultimate goal of care for these patients; improving their overall quality of life.”