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Trend in the Use of Antidepressant Pharmacotherapy and Diagnosis of Depression in the US

An Assessment of Office-Based Visits 1990 to 1998

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Abstract

Objective: To discern population-adjusted rates of office-based physician visits in the US documenting the use of antidepressant pharmacotherapy, a diagnosis of a depressive illness, or a diagnosis of a depressive disorder in concert with the use of antidepressant pharmacotherapy.

Materials and Methods: Data from the US National Ambulatory Medical Care Survey for the time-period of 1990 through 1998 were used to discern the population-adjusted rate of office-based physician visits documenting the use of antidepressant pharmacotherapy [tricyclic antidepressants (TCAs), selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors (SSRIs) or others], a diagnosis of depression (ICD-9-CM codes 296.2 to 296.36, 300.4 or 311) or both.

Results: Office-based visits documenting the use of antidepressant pharmacotherapy for any purpose escalated from 16 534 268 in 1990 to 40 925 824 in 1998, a 147.5% increase. The number of office-based visits documenting a diagnosis of depression increased 59.1% during this period, while the proportion of office-based visits documenting a diagnosis of depression and use of antidepressant pharmacotherapy increased 31.3%. Among patients with a diagnosis of depression, use of a TCA declined from 42.1% in 1990 to 9.7% in 1998. In contrast, use of an SSRI increased from 37.1% in 1990 to 65.6% in 1998. The population-adjusted rate of office-based visits documenting the use of antidepressant pharmacotherapy for any purpose increased from 6.7 per 100 US population in 1990 to 15.1 per 100 US population in 1998, a 125.4% increase; documentation of a diagnosis of depression increased from 6.1 per 100 US population in 1990 to 8.9 per 100 US population in 1998, a 45.9% increase; and the recording of a diagnosis of depression in concert with the use of antidepressant pharmacotherapy increased from 3.2 per 100 US population in 1990 to 6.1 per 100 US population in 1998, a 90.6% increase.

Conclusion: Over the time-period 1990 to 1998, there was a significant increase in the rate of diagnosis of depressive illness in the US, and a sustained preference for use of an SSRI in the treatment of depression.

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Acknowledgements

This study was supported by the Pharmacoeconomics and Pharmacoepidemiology Research Unit, College of Pharmacy, Washington State University, USA.

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Authors and Affiliations

  1. Pharmacoeconomics and Pharmacoepidemiology Research Unit, College of Pharmacy, Washington State University, P.O. Box 646510, Pullman, Washington, 99164-6510, USA

    Tracy L. Skaer, David A. Sclar, Linda M. Robison & Richard S. Galin

  2. Pullman Memorial Hospital, Pullman, Washington, USA

    Tracy L. Skaer & Richard S. Galin

  3. Graduate Program in Health Policy and Administration, Washington State University, Spokane, Washington, USA

    Tracy L. Skaer & David A. Sclar

  4. Graduate Program in Statistics, Washington State University, Pullman, Washington, USA

    David A. Sclar

  5. Washington Institute for Mental Illness Research and Training, Eastern Branch, Spokane, Washington, USA

    David A. Sclar

  6. Neuro-Psychiatric Institute, University of California at Los Angeles, Los Angeles, California, USA

    Richard S. Galin

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  1. Tracy L. Skaer
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Correspondence to Tracy L. Skaer.

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Skaer, T.L., Sclar, D.A., Robison, L.M. et al. Trend in the Use of Antidepressant Pharmacotherapy and Diagnosis of Depression in the US. CNS Drugs 14, 473–481 (2000). https://doi.org/10.2165/00023210-200014060-00005

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