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Antidepressants Prescribed Without Psychiatric Diagnosis

Study Documents Rise in Use of Antidepressants From Non-Psychiatric Illnesses

Many Explanations

Victor Reus, MD, professor of psychiatry at the University of California at San Francisco School of Medicine, says that there may be more going on here than meets the eye. For example, doctors often get reimbursed at lower rates for treating psychiatric conditions, so they may be more likely to use another code in the files. There are also still stigmas attached to psychiatric illnesses, which could play a role in the lack of diagnoses evident in some of these records.

“Some people may have had the diagnosis made by a psychiatrist and there was a relationship with a general practitioner who prescribed antidepressants,” he says. In these cases, the psychiatric diagnosis may be listed in a different set of records for the same person.

What’s more, “there are ample efficacy data to show that if you have depression that is secondary to stroke or heart attack, you are just as likely to achieve benefit from antidepressants as if you had an autonomous depression without a secondary medical illness,” he says.

The bottom line? “There are so many plausible explanations for what is going on,” he says.

Alan Manevitz, MD, a clinical psychiatrist at Lenox Hill Hospital in New York City, agrees with Reus.

“Some general practitioners may also be becoming more skilled at picking up softer signs of depression and intervening earlier, especially in people with co-existing medical problems that are linked to depression like heart attack or stroke,” he says.


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