Prescription of any kind of medicine is done to fulfill certain specific conditions. However, recent reports have indicated about unmindful tendencies of primary care physicians (PCPs) recommending antidepressants for minor issues, including insomnia and pain, which are not characteristic of depressive behavior.
A recent study, titled “Treatment Indications for Antidepressants Prescribed in Primary Care in Quebec, Canada, 2006-2015,” used details obtained from an electronic medical record comprising 100,000 patients. The scientists from the McGill University in Montreal, Canada, examined patterns of prescriptions of antidepressants of 185 PCPs in community-based primary care practices in Quebec over a span of 10 years.
The study, published online in the Journal of the American Medical Association in May 2016, revealed that prescriptions were designated as on-label or off-label depending upon if approval of the drug was for indication by Health Canada or the U.S. Food and Drug Administration (FDA) by September 2015.
Investigation of the data obtained indicated that only 55.2 percent of the 101,759 antidepressant medicines were administered to 19,734 patients who had manifested signs of depression. The most common off-label uses were for that of insomnia to the extent of 10.2 percent and pain to the extent of 6.1 percent.
The scientists observed that other conditions for which antidepressants were referred included fibromyalgia, migraine, vasomotor symptoms of menopause, nicotine dependence, premenstrual disorders and syndromes, sexual dysfunction, attention-deficit/hyperactivity disorder and urinary and digestive system disorders.
Also, the percentage of prescription of antidepressants for treatment of depression was reduced to a major extent. Elucidating on the findings, the authors of the study wrote, “Between 2006 and 2015, primary care physicians in Quebec commonly and increasingly prescribed antidepressants for non-depressive indications. When physicians prescribed antidepressants for insomnia and pain, they often prescribed antidepressants off-label.”
The findings of the study are important as it pinpoints at the negligence of the doctors while prescribing antidepressants as certain kinds of antidepressants can trigger potential risk of Alzheimer’s disease or dementia in extreme cases. Though the subjects of the study were limited to only a small population with only a small number of people investigated for antidepressant use, the authors stressed that findings did showcase the need to analyze evidence in favor of off-label antidepressant use.
Another point of concern was the fact that the patients who were prescribed antidepressants have been using prescription painkillers. This is pursuant to a recent review by the FDA pointing out that the number of patients having prescribed both an opioid analgesic and antidepressant benzodiazepine had increased from 2002 to 2014.
Emergency room visits by patients using both classes of these drugs have seen a spike in the U.S., resulting in law enforcement agencies at the federal level issuing a boxed warning against taking certain prescription opioids and antidepressants together.
Stressing on the risk involved in using opioids and antidepressants together, FDA Commissioner Dr. Robert Califf said, “It is nothing short of a public health crisis when you see a substantial increase of avoidable overdose and death related to two widely used drug classes being taken together.” Advising antidepressants for minor issues without taking into account the prior medications advised to patients can wreak havoc, including unwarranted addiction to them. This can also result in patients resorting to cheap and alternative drugs to satiate their drug cravings.
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