Doctors say there is no evidence to suggest that a rise in the number of anti-depressant drugs dispensed by NHS Tayside means there has been an increase in the number of people with depression.
It has emerged that the number of anti-depressants dispensed by the health board has risen by 20% since 2007/8. Last year NHS Tayside dispensed 153,076 items compared to 126,931 in 2007/8.
Over the same period the defined daily doses (DDD), the measure used to standardise the comparison of drug usage, rose by 16%.
The DDD stood at 5,596,652 in 2007/8 and rose to 6,513,384 in the last financial year.
Dundee councillor Lesley Brennan, who represents the East End ward, expressed concern at the rise.
She said: ”Depression is a public health issue, particularly when an estimated one in five adults is likely to be affected by some form of mental illness during their lives.
”Investment in alternatives to anti-depressants such as counselling and cognitive behavioural therapy will ensure more effective support for patients.
”Apart from the most serious cases, the daily use of such drugs should remain a last resort.”
But experts defended the rise, claiming it could be easily be accounted for by a number of factors.
Sheena Macgregor, head of clinical pharmacy for Dundee Community Health Partnership, said: ”There can be a number of reasons for an increase or decrease in the number of items for anti-depressants prescribed.
”GPs are actively screening patients for depression and are likely to use medicines as one of a range of treatment options.
”It is important, however, to note that anti-depressants are used for a range of medical conditions, not just depression, and so a rise in prescribed items does not necessarily mean a rise in cases of depression.
”Another important point is that the number of items prescribed is not the same as the number of people receiving prescriptions and there will be variation in the number of items prescribed to a person in a year depending on how often they receive prescriptions.
”For example, monthly prescriptions would be 12 items per year whereas bi-monthly prescriptions would only be six items per year.”
Dr David Christmas, consultant psychiatrist at NHS Tayside’s Advanced Interventions Service, agreed that the figures were not proof of a rise in depression across the region.
He said prescribing of anti-depressants was a ”complex issue” and ”observed rises” could be due to a number of reasons such as people getting the drugs for longer.
”This is a good thing, since current quidelines recommend that ‘uncomplicated’ depression should be treated for six months after recovery,” he said.
Dr Christmas added that anti-depressants are not limited to the treatment of depression but to all disorders affecting the central nervous system, ranging from Parkinson’s disease to epilepsy. The drugs can also be used to treat pain, migraines and even incontinence.
He added that most studies actually suggest the biggest concern is not over-diagnosis of depression, but under-diagnosis.
Dr Christmas said: ”Although we’ve seen increases in anti-depressant prescribing throughout the UK in recent years, we don’t know if this is because more people are getting anti-depressants or whether people are getting anti-depressants for longer.
”As far as we can tell from recent evidence, it’s the latter increases in anti-depressant prescribing can be accounted for by longer prescribing, which would be in line with current guidelines.”
Photo by David Cheskin/PA Wire