Apr 9, 2024 11:03 PM
https://www.statnews.com/2024/04/08/time...pressants/
EXCERPTS: The need for accessible depression treatment has never been greater. Multiple national surveys, including one I help lead, report high levels of depression. More than 1 in 10 adults in a U.S. Census survey reported needing therapy for mental health, and being unable to get it — including 1 in 4 who reported current depression or anxiety.
Access to psychiatrists is extremely limited in many areas of the U.S.: long wait times make a mockery of the 2008 mental health parity mandate. That means the vast majority of antidepressants are prescribed by non-psychiatrists, particularly primary care physicians. Yet many primary care practices struggle to provide the same kind of care for depression that they provide for other chronic illnesses. After the Covid-19 pandemic, even access to primary care can be hit or miss.
[...] Food and Drug Administration policy states that non-prescription medications must meet three criteria: they can be used for self-diagnosed conditions; there’s no need for a clinician’s involvement to be used safely; and they have a low potential for misuse and abuse.
In reality, many OTC products treat symptoms or rely on consumers to diagnose themselves — think yeast infections, acid reflux, or respiratory infections. In the case of major depression or generalized anxiety, screening surveys have been developed for primary care that could help people determine their likely diagnosis with at least the degree of confidence of many OTC applications.
What about use or misuse? Depression is associated with increased risk for suicide, and medication overdose is among the most common methods of suicide. But walk through the aisles at your local pharmacy and pick any given medicine off the shelf: the odds are good it is more dangerous in overdose than an SSRI. Fatal overdoses are far more likely to involve drugs other than antidepressants.
[...] Another objection to over-the-counter SSRIs is that not everyone believes in pills for depression. Some still question the biological basis of this disorder, despite the identification of more than 100 genes that increase depression risk and neuroimaging studies showing differences in the brains of people with depression.
To be sure, there are alternatives to pills. Certain talk therapies, like cognitive behavioral therapy, can be as effective as antidepressants, and some people prefer talking with a therapist to taking a medicine. But not everyone: weekly visits for eight to 12 sessions or more can entail substantial time and money. Here too, access to psychotherapists is a massive problem, particularly for individuals who seek to use insurance, or have none.
No treatment works for everyone, but around one in three people with depression get well with an initial antidepressant medication. Allowing over-the-counter access is not a panacea, but could open the door to a safe, effective, and inexpensive treatment for many who need it... (MORE - missing details)
RELATED (scivillage): Your dog is probably on Prozac. Experts say that says more about the American mental health crisis than pets
EXCERPTS: The need for accessible depression treatment has never been greater. Multiple national surveys, including one I help lead, report high levels of depression. More than 1 in 10 adults in a U.S. Census survey reported needing therapy for mental health, and being unable to get it — including 1 in 4 who reported current depression or anxiety.
Access to psychiatrists is extremely limited in many areas of the U.S.: long wait times make a mockery of the 2008 mental health parity mandate. That means the vast majority of antidepressants are prescribed by non-psychiatrists, particularly primary care physicians. Yet many primary care practices struggle to provide the same kind of care for depression that they provide for other chronic illnesses. After the Covid-19 pandemic, even access to primary care can be hit or miss.
[...] Food and Drug Administration policy states that non-prescription medications must meet three criteria: they can be used for self-diagnosed conditions; there’s no need for a clinician’s involvement to be used safely; and they have a low potential for misuse and abuse.
In reality, many OTC products treat symptoms or rely on consumers to diagnose themselves — think yeast infections, acid reflux, or respiratory infections. In the case of major depression or generalized anxiety, screening surveys have been developed for primary care that could help people determine their likely diagnosis with at least the degree of confidence of many OTC applications.
What about use or misuse? Depression is associated with increased risk for suicide, and medication overdose is among the most common methods of suicide. But walk through the aisles at your local pharmacy and pick any given medicine off the shelf: the odds are good it is more dangerous in overdose than an SSRI. Fatal overdoses are far more likely to involve drugs other than antidepressants.
[...] Another objection to over-the-counter SSRIs is that not everyone believes in pills for depression. Some still question the biological basis of this disorder, despite the identification of more than 100 genes that increase depression risk and neuroimaging studies showing differences in the brains of people with depression.
To be sure, there are alternatives to pills. Certain talk therapies, like cognitive behavioral therapy, can be as effective as antidepressants, and some people prefer talking with a therapist to taking a medicine. But not everyone: weekly visits for eight to 12 sessions or more can entail substantial time and money. Here too, access to psychotherapists is a massive problem, particularly for individuals who seek to use insurance, or have none.
No treatment works for everyone, but around one in three people with depression get well with an initial antidepressant medication. Allowing over-the-counter access is not a panacea, but could open the door to a safe, effective, and inexpensive treatment for many who need it... (MORE - missing details)
RELATED (scivillage): Your dog is probably on Prozac. Experts say that says more about the American mental health crisis than pets