Wednesday, August 05, 2009

A horrible new trend in depression management

So says this report published this week in the Archives of General Psychiatry.

According to the report, nearly 9% of patients started on antidepressants were also started on antipsychotics - an increase of 40% compared to 1996.

Of all the drugs out there there are perhaps none more uniformly detrimental to weight than the newest generation of antipsychotics where it's not even remotely abnormal to see patients gain 20-60lbs within a year of initiation.

Unfortunately these results don't surprise me at all as in my experience it's not just for depression where antipsychotics are inappropriately prescribed without considering the inevitable weight related consequences as they've also found favour with some physicians as sleep aids.

Bottom line?

Antipsychotics should be used to treat psychosis - and if someone's going to use them to augment therapy with an antidepressant or for another off label use they'd better darn well have exhausted every other possible treatment strategy.

Mark Olfson, MD, MPH; Steven C. Marcus, PhD (2009). National Patterns in Antidepressant Medication Treatment Archives of General Psychiatry, 66 (8), 848-856