The use of antidepressants is on the rise, especially among young people, and it's time we talk about it. A new study reveals a concerning trend: more Australians are taking antidepressants for longer periods. This is particularly noticeable in the 10-24 age group, where long-term use has skyrocketed by 110% between 2014 and 2023. The duration of treatment has also increased by 53%.
Dr. Cathy Andronis, Chair of RACGP Specific Interests Psychological Medicine, isn't surprised by these findings. She points to Australia's high antidepressant prescription rates, a growing youth mental health crisis, and recent cuts to mental health services.
"Australia has always been a high prescribing nation for antidepressants for all age groups, but we also know that we’ve got a youth mental health crisis, and the number of people with mental health symptoms in the under 30 age group has grown significantly in the last five to 10 years," she said.
But here's where it gets controversial... The government's decision to scrap Medicare item 2713, which supported mental health care, has made it harder and more expensive for people to access counseling and therapy. As a result, many are sticking with medication because it seems like the easiest option. This is a critical point, as it highlights the interplay between policy, access to care, and patient choices.
The study authors raise concerns about potential overprescribing, noting that 45% of those aged 10-24 stay on antidepressants for over a year, with a significant number still using them after two years. The Royal Australian and New Zealand College of Psychiatrists recommends reviewing medication use after 6-12 months, creating a potential conflict.
Dr. Lasantha Ranwala, the study's lead author, emphasizes that prolonged use can increase side effects and make withdrawal difficult. Withdrawal symptoms are often mistaken for a return of the original condition, leading to extended treatment.
Deprescribing, or safely reducing and stopping medication, isn't as simple as it sounds. Dr. Andronis explains it requires time-consuming consultations to assess the patient, explain the process, and provide tools to manage stress without medication.
And this is the part most people miss... The study, based on data from the Pharmaceutical Benefits Scheme from 2014-23, found that while long-term antidepressant use increased across the population, it stabilized slightly in 2023. The percentage of long-term users on lower doses remained constant, suggesting a need for more active deprescribing strategies. The authors suggest that healthcare providers may be hesitant to deprescribe due to concerns about withdrawal and destabilizing patients.
Associate Professor Andrew Andrade suggests that technology, such as predictive analytics and clinical decision-support tools, could help identify suitable patients for tapering and provide guidance. However, Dr. Andronis stresses that a patient's clinical history and a simple conversation are often the most effective ways to assess their needs.
In response to these findings, the RACGP has released a new guide for GPs on deprescribing SSRIs and SNRIs, aiming to minimize withdrawal symptoms and relapse. This guide includes a patient resource to help GPs support their patients through the process.
What do you think? Do you believe the current healthcare system adequately supports deprescribing and alternative mental health treatments? Share your thoughts in the comments below.
