H.A. Pincus, T.L. Tanielian, S.C. Marcus, M. Olfson, D.A. Zarin, J. Thompson, J.M. Zito, Prescribing trends in psychotropic medications, JAMA, 18 February 1998, 279 (7), 526-531

Article reviews changes between 1985 and 1993-1994 in prescribing patterns of SSRIs and other psychotropic medications - this whole class representing 8.8% of the US prescription drug market in 1994. Over this nine year time span, "all psychotropic drug visits" to doctors increased from about 33m to 46m; as a proportion of all visits, an increase from 5.1% to 6.5%.

Visits for depression increased from 10.99m in 1988 to 20.43m in 1993 and 1994. For reasons discussed but unclear, the proportion of visits for depression when a drug was prescribed increased for psychiatrists but not for primary care physicians.

This article contains useful data on consumption of antidepressants. Authors conclude "it is premature to draw any conclusions about appropriateness or quality of care". Paper seems thin on discussion. Authors appear not to question the widely held view that more SSRI prescribing = better mental health.

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