Elon Musk's claim that antidepressants are 'overprescribed' in the U.S. is challenged by a psychiatrist who points to the complexities of antidepressant use and the need for a balanced approach.
Elon Musk's claim on X that antidepressants are 'overprescribed' in the U.S. is not entirely accurate, according to a psychiatrist contacted by Newsweek. Professor of Epidemiology at Columbia University Irving Medical Center Mark Olfson told Newsweek that the situation is more nuanced. 'In fact, we have a problem with both over-prescription and under-prescription of antidepressants,' he said.
Olfson explained that some adults prescribed antidepressants could have been effectively treated with cognitive behavioral therapy or other evidence-based psychotherapies if they had been accessible. He also noted that other adults remain on antidepressants longer than necessary. However, he stressed that a significant number of adults with serious depression and anxiety could benefit from antidepressants but lack access to treatment.\In the U.S., approximately one in eight adults takes an antidepressant medication, and antidepressant use has risen in recent years. Between April 2018 and March 2020, there were 29.2 million antidepressant prescriptions in the U.S. This increased to 32.1 million between April 2020 and 2022. The uptick is attributed to higher rates of depression within the U.S. population and an increase in 'telemental healthcare,' which has expanded the need for antidepressants and made them more accessible. Consultant Psychiatrist and Fellow of the U.K.'s Royal College of Psychiatrists Dr. Paul Keedwell offered several possible explanations for the U.S.'s leading position in antidepressant prescriptions. He pointed to the highly competitive and individualistic nature of American culture, coupled with high levels of work-related stress. He also highlighted the high awareness of mental health issues and the willingness to seek help in the U.S. Keedwell further suggested that the U.S. being one of only two countries that allows direct-to-consumer marketing of antidepressants inevitably increases pressure on doctors to prescribe. Finally, he expressed concerns about some doctors having a low threshold for prescribing, which, in a private system where providers compete, allows patients to seek out doctors who will prescribe.\Keedwell also noted that, unlike many other countries, the U.S. lacks a ban on gifts or incentives to physicians, which could influence prescribing practices. Despite the overall increase in antidepressant prescriptions in the U.S., there remains a concerning issue of under-prescribing. Olfson stated that household surveys reveal numerous U.S. adults with major depression and anxiety disorders who could benefit from antidepressant treatment but are not receiving it. While progress has been made in expanding access to mental health care and reducing stigma, significant barriers like financial constraints, geographic limitations, and attitudinal biases continue to prevent many from obtaining necessary treatment
Antidepressants Over-Prescription Under-Prescription Mental Health Depression Anxiety Telemental Healthcare U.S. Healthcare
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