Americans take an amazing number of medications in an attempt to ease their anxiety or relieve their depression. According to our calculations, more than 280 million prescriptions are dispensed annually for antidepressants and anti-anxiety agents. A new report from the Centers for Disease Control and Prevention (CDC) reveals that one person in 10 takes an antidepressant. Nearly as many swallow a sedative.

During the 1970s Valium and Librium were household names because they were among the most prescribed drugs in America. Today, generic anxiolytics like alprazolam, lorazepam, clonazepam, diazepam and temazepam have replaced the old brand name nerve pills. Antidepressants such as sertraline, citalopram and trazodone compete with brands such as Lexapro, Cymbalta, Effexor and Pristiq.

It’s hardly any wonder so many people are taking such drugs. We live in stressful economic times. Counseling can be expensive. Even if someone has insurance, there is often a cap on how many sessions a person may get with a psychotherapist. A $4 a month generic drug seems like a cost-effective substitute.

According to the new CDC report, fewer than one third of those taking an antidepressant medication were treated by a mental health professional in the past year. That means that the majority of the prescriptions may be written without an in-depth understanding of the benefits and risks of these drugs.

For example, the majority of the prescriptions for antidepressants are being used to treat mild to moderate depression. Prescribers such as family practice physicians, nurse practitioners and internists may not realize that the FDA has approved such drugs for treating “major depressive disorder,” but not for mild to moderate depression.

A meta-analysis of well-conducted clinical trials has found that the benefits of antidepressants for people with mild or moderate depression were “nonexistent to negligible” compared to placebo (Journal of the American Medical Association, Jan. 6, 2010). That means millions of people are taking medications that may not help them.
These drugs do have side effects, however. Some people experience headaches, nausea, dizziness, diarrhea, anxiety, insomnia or sexual dysfunction.

Prescribers don’t always warn patients that both antidepressant and anti-anxiety drugs may be very hard to stop. They may not have a detailed plan to help patients withdraw from drugs like alprazolam, lorazepam, sertraline or citalopram.

We offer more information on these medications in our gude to Psychological Side Effects. For more about effective non-drug approaches, we offer our Guide to Dealing with Depression.

Anti-anxiety agents and antidepressants can be very helpful, especially when combined with therapy. To be used effectively, however, patients and prescribers should be aware of their benefits and risks.

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  1. Kd

    What an interesting article. Americans are known, however, to take pills for anything bothering them. This has been true for decades. Our society is very complex. One of the hardships of the American household is that family members are spread out far and wide, so then, there is not much emotional support, and for that matter, in the past, when extended families lived out on farms, in bad times they could share whatever income they had.
    When you lose your job and you worry all the time about how you will pay for your food and transportation costs even to interview for a job (stressful), of course you need help. I do not find it surprising that this recession (actually, a depression, what with a true unemployment rate of 25%) causes people to ask their family doctor (not a psychiatrist, which will end up costing more) to prescribe an antidepressant. No pun intended, but I see it now!

  2. Sheri

    I have had very good luck for over a year now using GABA receptors given to me by an integrative MD. That, along with some 5HTP, fish oil and exercise, (which I had been doing before), usually keeps most of my anxiety and depression at bay.

  3. Paul 43

    I think ALL anti-depressants warp your mind instead of healing it—that is why it it is so hard to get off them. The normal family doctor does not have enough training to prescribe them.

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