Aug 10

Antidepressants are now the best-selling drugs in the USA – and their consumption has doubled in the last 10 years.

This was established by a meta-analysis of studies from 1996 to 2005 among 50,000 children and adults and published in the Archives of General Psychiatry. Currently 10 percent of Americans – about 27 million people – are taking antidepressants, approximately twice as many as in 1996.

Only half of these people, however, are actually treated solely for depression, the rest are taking the drug because of back pain, fatigue, insomnia and other problems. So the increased consumption doesn’t necessarily mean that more people are depressed, but that the drugs are used to manage or facilitate everyday life, and probably also as mood enhancers.

This also fits the other findings, namely that the proportion of people who take antidepressants and who are undergoing psychotherapy at the same time dropped from 31 to 20 percent. Presumably many feel insecure about dealing with the reasons for their psychological problems or are uncertain about whether psychotherapy could really help – while the belief in the effectiveness of drugs is increasing. Also, ‘dropping a pill’ is simple and costs less money – at least in the short run, especially since many American insurance companies don’t pay for psychotherapy, and doctors prefer prescribing drugs over dealing with their patients thourougly as this saves valuable time for other patients waiting in the queues.

The study’s authors argue that an essential factor for these changes may represent the enormous dedication of funds for advertising: for advertisements aiming at end users (patients), 32 million USD were used in 1996, but already 122 million USD in 2005. Only 14% of the proceeds from sales had been reinvested in research and production by the industry – the rest goes to marketing and profit distributions 1.

Update:
A reader of this post has sent me a graphic his company, MedicalBillingAndCodingonline.org, has created and released under the Creative Commons License. I think it illustrates the major aspects of the current trends just great. Please click here or on the image at the right or download a large version of the graphcic from the author’s site.

(Sources: New England Jornal of Medicine in an interview by The Nation, 20090809; “National Patterns in Antidepressant Medication Treatment” by Mark Olfson & Steven C. Marcus in: Arch Gen Psychiatry 2009;66(8):848-85)

Jul 22

At a conference organized by the Health Promotion Fund for a Healthy Austria, experts recently lectured on approaches to resolve critical future scenarios. One of the core points was the question of the affordability of health care.

Obesity is one of the most pressing health problems and is consistent across all age and social groups. One in five pupils between six and 15 years has an excessively high body weight, eight percent of them are actually obese. Of the adults between 18 and 65 years, almost half are overweight or obese. “One consequence of these developments is an increasing wave of disease and therefore costs to the health care system, because being overweight is a major risk factor for cardiovascular disease, type 2 diabetes and certain cancers,” said Ch. Hörhan, head of the funds.

Stress, on the other hand, is an indirect co-causing factor for cardiovascular diseases and mental disorders – albeit indirect and thus often underestimated by health policies. According to surveys, the percentage of Europeans feeling stressed out has raised significantly over the last 10 years. The number of prescribed psychotropic drugs has also increased, as has the number of sick days due to mental problems according to one of the contributors. Among the reasons for invalidity pensions, mental illnesses is already in second place with 29 percent.

Stress can not only be caused by heavy workload, but also by financial problems, difficulties within the social environment or worries about the future. In the past few years, the influence of social, economic and social factors on the health of the population has become clearer – but still with only little consequence on health policies.

Sidenote by R.L.Fellner: according to latest research, apart from other hormonal changes involved by stress, cortisol distribution increases – under certain conditions, this can be a contributing cause for obesity (Cushing’s Syndrome / Hypercortisolism [more]).

22.03.20