The increased use of antidepressants over the past two decades has usually been seen as a pointer towards higher rates of depression or an over-diagnosis of depression.

In the US, especially, figures reveal that more than one in 10 teens and adults use antidepressants and prescriptions had quadrupled between 1988-1994 and 2005-2008.

But researchers in Canada have found that all these antidepressant prescriptions don’t point towards a specific rise in diagnoses of depression – in fact, the study showed 45% of those prescriptions were to treat different complaints.

The study, published in May and concentrating on 101,759 antidepressant prescriptions written by 158 physicians for 19,734 patients in Quebec, Canada from 2006 to 2015, revealed those prescriptions were indicated for depression only 55% of the time.

The most common alternative uses for antidepressants – including unapproved “off-label” uses – were:

  • Anxiety: Although this is approved in the US by the FDA, nearly one in five prescriptions (18.5%) were actually to treat anxiety.
  • Insomnia: Although sleep disorders and depression often go hand-in-hand most antidepressants aren’t approved to treat insomnia – but despite being off-label, they accounted for around 10% of the study’s prescriptions.
  • Pain: It’s well-known that antidepressants help alleviate the perception of pain in those suffering long-term or chronic pain and, although most of them were off-label, they still accounted for 6% of the presciptions.
  • Panic disorders: The study noted 4% of prescriptions were written for issues such as social phobia, panic attacks and agoraphobia.
  • Fibromyalgia: This disorder is associated with pain, sleep issues and fatigue and accounted for 1.5% of antidepressant prescriptions.
  • Migraines: The class of antidepressants known as tricyclics are known to help control migraines and their associated dizziness, nausea and pain and, although it is still classified as an off-label use, they made up 1.5% of the study’s prescriptions.
  • Obesessive-compulsive disorder: Some antidepressants are approved to treat OCD and they accounted for 1.1% of the study’s prescriptions.
  • Menopause: Because they have been shown to help control issues such as night sweats and hot flushes, antidepressants prescribed for menopausal symptoms made up 0.8% of the prescriptions.

The findings have caused a split amongst commentators, some of whom associate the idea of off-label use with potential harm. There are others, though, such as D Shailesh Jain from Texas Tech University Health Sciences Center, who points to a long history of alternate uses for the drugs especially in treating anxiety.

“It is very unlikely that there is no element of anxiety with depression and there is almost always an element of depression with anxiety,” Jain said in an interview with MRT.com. “Pure depression or pure anxiety is very uncommon. One may predominate, but they very likely coexist.
“It’s not like somebody is coming out of the blue and saying, ‘OK, take this antidepressant for this or that’. It’s just that there is no label on it, but there is plenty of scientific evidence in literature and otherwise.”
Robert Street Clinic’s psychologists, psychotherapists and psychiatrists are well-versed in knowing whether antidepressants are right for you – regardless of age or symptoms. For more information, email us at info@robertstclinic.co.nz, call us on 09 973 5950, or contact us via the website.