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David Mrazek, M.D.
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David Mrazek, M.D.
David Mrazek, M.D.
Dr. David A. Mrazek is chair of the Department of Psychiatry and Psychology at Mayo Clinic, Rochester, Minn., and a professor of psychiatry at College of Medicine, Mayo Clinic. Dr. Mrazek has developed a federally funded psychiatric pharmacogenomics research program and implemented clinical psychiatric pharmacogenomics services at Mayo Clinic.
He has received numerous awards including the Award for Creativity in Psychiatric Education from the American College of Psychiatrists and the Agnes Purcell McGavin Award for Distinguished Career Achievement in Child and Adolescent Psychiatry from the American Psychiatric Association. He currently serves as chairman of the board of the American Board of Psychiatry and Neurology.
Dr. Mrazek has focused his current efforts on using pharmacogenomics testing to improve clinical care. One of his specific goals is to decrease the risks of taking psychiatric medications.
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Depression blog
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Dec. 7, 2011
Antidepressant use soaring among Americans 12 and over
By David Mrazek, M.D.
One in 10 people over age 12 in the United States is taking an antidepressant, according to the National Health and Nutrition Examination Survey, which is conducted by the Center for Disease Control.
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Women between the ages of 40 and 59 are the most likely group to take antidepressants. In this age range, 23 percent of U.S. women are taking one. While most of you are well informed about the treatment of depression, I imagine that this number comes as a bit of surprise. This is in part because some people still feel uncomfortable sharing with others that they are taking an antidepressant and feeling better.
The survey also found that 60 percent of the respondents had been on their antidepressant for at least two years. As we've discussed before here, this is probably a good thing, as relapse is a little less likely if you've had a sustained period of recovery. However, it was a bit more surprising to learn that 14 percent of the respondents had been taking their antidepressant for 10 years or longer. Most physicians would consider it appropriate to see if you can sustain a remission after two years and would suggest a trial of slowly discontinuing the medication to see if it's still needed.
While this is a bit risky, it's good practice, because some people won't relapse on discontinuation and can get by without the cost and inconvenience of taking a medication every day. However, if a relapse does occur after a long successful treatment, it makes sense to reinstate the treatment and provide it for a prolonged period which could extend to 10 years if the person continues to do well.
Another interesting aspect of the survey was that most people who are taking a single antidepressant have not seen a mental health clinician in the past year. This is certainly becoming more common as those people who have a good response to an initial antidepressant are most often treated by a primary care physician.
Clearly, millions of people are taking these medications on a sustained basis. This represents a change in practice as 20 years ago only about two percent of patients were taking antidepressants. An interesting question is why has the number of people taking these medications increased by 400 percent in two decades? I don't think we have an absolutely clear answer, but there are two factors contributing to the change.
- First, medications have been getting steadily better over the past 20 years.
- Second, there's less stigma. There's still far too much stigma, but it's decreased.
As you've shared on the blog, the process of finding the right antidepressant can be difficult, but there are now 20 options and the chances of finding one that will help have increased.
It would be interesting to hear your opinions regarding the reasons so many Americans have made the decision to take these medications.
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