Are antidepressants overprescribed? No

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f190 (Published 22 January 2013)
Cite this as: BMJ 2013;346:f190

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  1. Ian C Reid, professor of psychiatry
  1. 1Division of Applied Medicine, University of Aberdeen, Aberdeen, UK
  1. i.reid{at}abdn.ac.uk

Des Spence (doi:10.1136/bmj.f191) believes that the rising prescription rates for antidepressants reflect overmedicalisation, but Ian Reid argues that prescribing is cautious and appropriate

The notion that antidepressants are overprescribed is certainly popular and hardly new. There is profound suspicion of them: antidepressants are regularly caricatured in the media as an addictive emotional anaesthetic, peddled by thoughtless general practitioners as a matter of convenience, and taken by credulous dupes who seek “a pill for every ill.” Little wonder that decrying antidepressant prescription is such a sure-fire crowd pleaser for the press (for example, “Ministers act to wean Scotland off £55m-a-year antidepressant habit,” Scotsman, 6 December, 2006).

The reality is very different. Depressive disorder is a common, recurrent, debilitating, and potentially lethal illness. Psychiatric drugs, including antidepressants, have equivalent effectiveness to drugs in other branches of medicine (as detailed in a review of 94 meta-analyses comparing drug effect sizes in medical disease with drugs in psychiatric disorder1). Given recent demonstrations that depression is still under-recognised and undertreated,2 3 the claim that antidepressants are …

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