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Monday, December 8, 2014

Antidepressant Use is No Longer Increasing in Canada

I have just published two papers about major depression in Canada in the Canadian Journal of Psychiatry (abstracts available here). One of these is concerned with the way in which people view their mental health. Everybody seems to feel that life is more stressful now than it was in the past - but when you look at the proportion of people reporting that their lives are very much or extremely stressful in surveys that have been conducted in Canada over the past 20 years there is actually a decline in the proportion reporting this. On the other hand, people are becoming more likely to report that their mental health is only fair or poor. My interpretation of this trend is that it reflects a changing way of looking at mental health - rather than interpreting distressing symptoms as being due to an external cause, people seem increasingly likely to interpret this more internally as a mental health issue. This trend reflects increasing mental health literacy. The second paper is an analysis of trends in antidepressant use over the past 20 years in Canada. After large increases in the 1990s and 2000s, there appears to be no increase over the past 5-10 years. This applies to traditional antidepressant medications. Other sources of data suggest that there has been an increased use of second generation antipsychotic medications for mood disorders including major depression. This trend is consistent with Health Canada's approval of their use as an adjunctive treatment.