Antidepressants used for more than depression, Quebec study

The term “antidepressant” is increasingly becoming a misnomer, suggests new study published Tuesday in the Journal of the American Medical Association.

Scientists from McGill University in Montreal had suspected that antidepressants were being used to treat conditions other than depression, but little research existed on the topic.

Jenna Wong, a Ph.D student in the department of Epidemiology, Biostatistics and Occupational Health, and colleagues analyzed treatment indications for antidepressants and assessed trends in antidepressant prescribing for depression.

The scientists used data from an electronic medical record and prescribing system that has been used by primary care physicians in community-based, fee-for-service practices around 2 major urban centers in Quebec, Canada. The study included prescriptions written for adults between January 2006 and September 2015 for all antidepressants except monoamine oxidase inhibitors. Physicians participating in the study had to document at least 1 treatment indication per prescription using a drop-down menu containing a list of indications or by typing the indication(s).

During the study period, 101,759 antidepressant prescriptions (6 percent of all prescriptions) were written by 158 physicians for 19,734 patients. Only 55 percent of antidepressant prescriptions were indicated for depression. Physicians also prescribed antidepressants for anxiety disorders (18.5 percent), insomnia (10 percent), pain (6 percent) and panic disorders (4 percent). For 29 percent of all antidepressant prescriptions (66 percent of prescriptions not for depression), physicians prescribed a drug for an off-label indication, especially insomnia and pain. Physicians also prescribed antidepressants for several indications that were off-label for all antidepressants, including migraine, vasomotor symptoms of menopause, attention-deficit/hyperactivity disorder, and digestive system disorders.

“The findings indicate that the mere presence of an antidepressant prescription is a poor proxy for depression treatment, and they highlight the need to evaluate the evidence supporting off-label antidepressant use,” the authors write.

Agencies/Canadajournal