National Patterns in Antidepressant Medication Treatment

Olfson, Mark; Marcus, Steven C.

doi:10.1001/archgenpsychiatry.2009.81

Cited by 674 publications

(523 citation statements)

References 55 publications

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“…Our question about drug use during most of the previous 4 weeks would not include short‐duration users, but this exclusion is an advantage for studying of the effects of psychotropic drugs on VTE risk. That a sizeable proportion of women who reported taking an antidepressant did not report being treated for anxiety or depression, and similarly that not all women who reported they were being treated for depression or anxiety reported use of antidepressants, is consistent with previous US and UK research 26, 27, 28…”

Section: Discussionsupporting

confidence: 83%

“…Antidepressants are used to treat depression, anxiety, and various pain‐related conditions, and the utilization of these drugs has been increasing in the United Kingdom, United States, and elsewhere 27, 36, 37. National quality standards in the United Kingdom, which recommend that people who may have depression are assessed to determine the severity of the condition and identify appropriate treatments,38 and a national objective to increase the proportion of US adults with major depressive disorders who receive treatment,39 may lead to further increases in antidepressant use.…”

Section: Discussionmentioning

confidence: 99%

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Antidepressants, Depression, and Venous Thromboembolism Risk: Large Prospective Study of UK Women

Parkin

Balkwill

Sweetland

et al. 2017

JAHA

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BackgroundSome investigators have reported an excess risk of venous thromboembolism (VTE) associated with depression and with use of antidepressant drugs. We explored these associations in a large prospective study of UK women.Methods and ResultsThe Million Women Study recruited 1.3 million women through the National Health Service Breast Screening Programme in England and Scotland. Three years after recruitment, women were sent a second questionnaire that enquired about depression and regular use of medications in the previous 4 weeks. The present analysis included those who responded and did not have prior VTE, cancer, or recent surgery. Follow‐up for VTE was through linkage to routinely collected National Health Service statistics. Cox regression analyses yielded adjusted hazard ratios and 95% CIs. A total of 734 092 women (mean age 59.9 years) were included in the analysis; 6.9% reported use of antidepressants, 2.7% reported use of other psychotropic drugs, and 1.8% reported being treated for depression or anxiety but not use of psychotropic drugs. During follow‐up for an average of 7.3 years, 3922 women were hospitalized for and/or died from VTE. Women who reported antidepressant use had a significantly higher risk of VTE than women who reported neither depression nor use of psychotropic drugs (hazard ratio, 1.39; 95% CI, 1.23–1.56). VTE risk was not significantly increased in women who reported being treated for depression or anxiety but no use of antidepressants or other psychotropic drugs (hazard ratio, 1.19; 95% CI, 0.95–1.49).ConclusionsUse of antidepressants is common in UK women and is associated with an increased risk of VTE.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Antidepressants, Depression, and Venous Thromboembolism Risk: Large Prospective Study of UK Women

Parkin

Balkwill

Sweetland

et al. 2017

JAHA

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“…In most studies in other countries, lower income or lower educational attainment was associated with a lower prevalence of depression treatment, or there was no association [22][23][24][25][26]. In the present study, however, the lowestincome quintile showed the highest rate of depression treatment among respondents with psychological distress.…”

Section: Discussioncontrasting

confidence: 72%

“…In the present study, however, the lowestincome quintile showed the highest rate of depression treatment among respondents with psychological distress. Although there is generally a barrier to medical treatment for the lower-income population, particularly in the United States, which lacks nationalized health care [24,25], in Japan this barrier appears to be relatively low due to the universal coverage of health insurance.…”

Section: Discussionmentioning

confidence: 99%

Influences of income and employment on psychological distress and depression treatment in Japanese adults

Fukuda

Hiyoshi

2011

Environ Health Prev Med

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Objectives Psychological distress is a health issue of critical importance, especially in people of working age in developed countries, including Japan. This study examined the relationships of income and employment arrangement with psychological distress and treatment of depression in a national sample of Japanese adults. Methods Data for 10,959 men and 11,655 women 25-59 years of age, obtained from the Comprehensive Survey of the Living Conditions of People on Health and Welfare in 2007, were examined. Health outcomes were psychological distress measured by the Japanese version of the K6, subjective complaints and medical treatment of depression. Explanatory variables included marital status, employment arrangement, and household income. The relationships between health outcomes and explanatory variables were examined using multiple logistic regression analyses. Results Lower income and unemployment were associated with a higher prevalence of psychological distress and treatment of depression. The association between psychological distress and income showed a threshold: the lowest income quintile had an especially high prevalence, while other quintiles had similar prevalences. The prevalence of depression treatment in those with psychological distress was significantly lower in the highest income quintile than in all the other income groups, and the prevalence was also significantly lower in employed than in unemployed respondents. Conclusions This study showed clear relationships of lower income and unemployment with psychological distress and depression treatment. It has been suggested that people with higher socioeconomic status and full-time work may be reluctant to consult professionals and receive medical treatment, despite their psychological distress. Comprehensive mental health interventions are required to prevent psychological distress in all socioeconomic strata of the population.

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“…Although depression is a significant health problem in the United States and antidepressants are heavily prescribed (2), the mechanism of action for these drugs is not understood. Further, nearly a third of those treated with these drugs do not achieve remission of their depression (3).…”

mentioning

confidence: 99%

Antidepressants Accumulate in Lipid Rafts Independent of Monoamine Transporters to Modulate Redistribution of the G Protein, Gαs

Erb¹,

Schappi

Rasenick

2016

Journal of Biological Chemistry

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Depression is a significant public health problem for which currently available medications, if effective, require weeks to months of treatment before patients respond. Previous studies have shown that the G protein responsible for increasing cAMP (G␣ s ) is increasingly localized to lipid rafts in depressed subjects and that chronic antidepressant treatment translocates G␣ s from lipid rafts. Translocation of G␣ s , which shows delayed onset after chronic antidepressant treatment of rats or of C6 glioma cells, tracks with the delayed onset of therapeutic action of antidepressants. Because antidepressants appear to specifically modify G␣ s localized to lipid rafts, we sought to determine whether structurally diverse antidepressants accumulate in lipid rafts. Sustained treatment of C6 glioma cells, which lack 5-hydroxytryptamine transporters, showed marked concentration of several antidepressants in raft fractions, as revealed by increased absorbance and by mass fingerprint. Closely related molecules without antidepressant activity did not concentrate in raft fractions. Thus, at least two classes of antidepressants accumulate in lipid rafts and effect translocation of G␣ s to the non-raft membrane fraction, where it activates the cAMP-signaling cascade. Analysis of the structural determinants of raft localization may both help to explain the hysteresis of antidepressant action and lead to design and development of novel substrates for depression therapeutics.Depression is the leading cause of long term disability in the industrialized world (1). Although depression is a significant health problem in the United States and antidepressants are heavily prescribed (2), the mechanism of action for these drugs is not understood. Further, nearly a third of those treated with these drugs do not achieve remission of their depression (3). Although most of these drugs do interfere with monoamine uptake or catabolism, they exert this effect within hours, even though most of the compounds require weeks before alleviation of symptoms is observed (4). Thus, other targets for antidepressant drugs may exist (4).Chronic antidepressant treatment engages signaling pathways apart from increasing monoamine density in the synaptic cleft. One of these is an increased accumulation of cellular cAMP and sequelae thereof, such as increased cAMP-response element-binding protein (CREB) phosphorylation and increased transcription of cAMP-regulated genes (e.g. BDNF) (5). Moreover, positron emission tomography (PET) evidence suggests that cAMP is diminished throughout the brain of depressed human subjects (6). Thus, it is possible that some antidepressant effects are mediated through induction of the cAMP-generating system, including G␣ s and adenylyl cyclase.Previous studies demonstrated that chronic antidepressant treatment translocates G␣ s from lipid rafts, whereupon it engages in a more facile activation of adenylyl cyclase (7,8). Lipid rafts are regions of the plasma membrane rich in caveolin, cholesterol, sphingolipids, and cytoskeletal an...

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National Patterns in Antidepressant Medication Treatment

Cited by 674 publications

References 55 publications

Antidepressants, Depression, and Venous Thromboembolism Risk: Large Prospective Study of UK Women

Antidepressants, Depression, and Venous Thromboembolism Risk: Large Prospective Study of UK Women

Influences of income and employment on psychological distress and depression treatment in Japanese adults

Antidepressants Accumulate in Lipid Rafts Independent of Monoamine Transporters to Modulate Redistribution of the G Protein, Gαs

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