The marketing of Depession: Montreal Gazette

Women rely more on antidepressants, report finds
Prescriptions up 73 per cent in 4 years. Researcher blames increased
marketing of new drugs for emotional disorders

CHARLIE FIDELMAN
The Gazette
Tuesday, November 22, 2005

A majority of Canadian women seeking medical help for emotional problems
are leaving their doctor's office with a prescription for an antidepressant, a new study shows.

"Women are prescribed twice as many psychotropic drugs as men," Vancouver-based health policy researcher Jane Currie said yesterday. "Clinical trials results show these drugs have risks and we don't know what the long-term effects are."

A new class of drugs called selective serotonin reuptake inhibitors are being sold for a wide range of symptoms from anxiety, panic, shyness and insomnia to premenstrual syndrome and compulsive shopping, among other complaints.

Prescriptions jumped to 15.6 million in 2003, up from nearly 9 million in 1999, making depression the fastest-rising diagnosis in doctors' offices.

Two-thirds of users are women, Currie pointed out.

"The prevalence has skyrocketed," said Currie, who draws a link between an epidemic rise in emotional disorders and the marketing of drugs designed to treat these conditions, which are increasingly understood as "a biological phenomenon."

"It's a strange correlation that this has happened since the drugs have come on the market," Currie said, starting with the popular Prozac in the 1980s.

Women and Health Protection, a national working group funded by Health Canada, commissioned the study, titled the Marketization of Depression: Prescribing SSRI Antidepressants to women.

"There's a strong concern that more and more women are being put on them for reasons that are questionable and it's not the best use of health-care dollars," the group's co-ordinator, Anne Rochon Ford, said.

Widespread use of antidepressants among women reflects the fact that more women than men use the medical system.

That's the classic but cliche view that "women go to their doctors and men drink," Rochon said, when the problem is what is being classified as depression.

"The definition of depression is an elastic thing that has expanded to ridiculous proportions," Rochon said. "We've become a nation that pops a pill for just about anything."

Like Valium and an earlier generation of antidepressants, these drugs have always been heavily prescribed to women, Shree Mulay, director of the McGill Centre for Research and Teaching on Women, said.

"We have every reason to be concerned," Mulay said. Not only are "social problems being treated with medicine, but there's the question of (drug addiction) and side effects."

Health advocates say that non-drug therapies - exercise, nutrition counselling, support and psychotherapy - may be more effective treatment than drugs.

It's not one-size-fits-all in depression, said Remi Quirion, head of the Douglas Hospital Research Centre in Verdun.

"I'm totally convinced the increase in diagnosis is because there's less and less stigma associated with depression and other forms of mental illness," Quirion said. "Depression is a brain disorder that can be treated with SSRI or with psychotherapy, but it must be treated.

"I think it was vastly underdiagnosed before," he added.

But Alan Cassels, drug policy researcher at the University of Victoria and co-author of Selling Sickness, How the World's Biggest Pharmaceutical Companies are Turning Us All Into Patients, said the impact of marketing on therapy is undeniable.

Many people lead hectic, stressful, difficult lives, juggling careers, caring for children and aging parents, Cassels said.

"But does that mean you have a serotonin imbalance in the community? Instead of changing the social environment, we are modifying the chemical environment with drugs."

For Currie's report on the web: www.whp-apsf.ca/en/index.html

cfidelman@thegazette.canwest.com

(c) The Gazette (Montreal) 2005