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2.8 million prescriptions for top mental health drugs in 2013

Irish patients are being prescribed ever increasing amounts of medication designed to combat the ...
Newstalk
Newstalk

17.40 12 Aug 2015


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2.8 million prescriptions for...

2.8 million prescriptions for top mental health drugs in 2013

Newstalk
Newstalk

17.40 12 Aug 2015


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Irish patients are being prescribed ever increasing amounts of medication designed to combat the symptoms of depression and anxiety.

Physicians here - who treat patients on medical cards - wrote 2.85 million prescriptions for seven of the most popular depression and anxiety medications in 2013, compared to 2.6 million in 2011.

Newstalk.com studied HSE medical card numbers for the antidepressant and sedative drugs in question and found marked increases in the number of times they were prescribed over three years in more than half of the drug types reviewed. 

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In 2013, despite a small decrease, nearly one million scripts for benzodiazepines were written while 1.9 million scripts were written for antidepressants.

The combined figures for antidepressants and benzodiazepams show a steady increase over three years, rising from 2.5 million in 2011; to nearly 2.8 million in 2012 arriving at a total of almost 2.85 million in 2013 (the latest year for which figures are available).

Some 1.97 million people were eligible for medical cards in 2013.

An audit of 81 pharmacies published in the Irish Medical Journal showed fewer than one fifth of prescriptions reviewed (18.8%) were fully compliant with benzodiazepine assessment criteria.

There was a slight decrease in the number of prescriptions written for benzodiazepines (-19,000) between 2011 and 2013, but a massive increase for antidepressants of more than 275,000.

The number of prescriptions written for benzodiazepines remained sky-high, despite the fall, at nearly 950,000.

A sick nation

The World Health Organisation estimates depression will become the most common sickness in industrialised countries by 2030, while Aware suggests one in nine people will suffer a primary anxiety disorder.

*Prescription numbers published under annual figures for the HSE's primary care reimbursement service (GMS: Top 100 most commonly prescribed products in the order of prescribing frequency)

 

Newstalk.com looked at figures for a handful of the drugs commonly prescribed in the treatment of mental health:

  • Diazepam and Alprazolam - drugs known perhaps more commonly by their brand names Valium and Xanax - both benzodiazepines from the psychoactive drugs group commonly used as tranquilisers.
  • Antidepressants Venlafaxine (brand name Effexor); Escitalopram (Lexapro); Mirtazapine (Mirap/Mirtazapin); Citalopram (Cipramil) and Sertraline (Lustral).

Inappropriate benzodiazepine prescription persists

The medical card figures analysed here showed a drop in the number of benzodiazepines like Valium and Xanax being prescribed, but the numbers remain stubbornly high.

Physicians prescribed the drugs 19,000 fewer times in 2013 than they did in 2011, but almost a million (943,961) scripts for benzodiazepine were nonetheless written.

To show just how commonly prescribed benzodiazepines are, approximately two scripts for the drugs are presented in pharmacies every day.

An audit of 81 community pharmacies published in the Irish Medical Journal in March 2015 showed fewer than one fifth of prescriptions they reviewed (18.8%) were fully compliant with benzodiazepine assessment criteria.

Medical guidelines say benzodiazepines should not ideally be prescribed for longer than 2-4 weeks but the IMO's research shows inappropriate prescribing practices persist in both general practice and residential care settings.

In addition, the organisation found the lowest recommended dose was frequently not the dose being prescribed.

To show just how commonly prescribed benzodiazepines are, approximately two scripts for the drugs are presented in pharmacies every day.

The benzodiazepam alprazolam (xanax) was prescribed 450,742 times in 2013; 465,698 in 2012 and 456,466 times in 2011.

Meanwhile, diazepam (valium) was prescribed 493,219 in 2013; 514,350 in 2012; and 506,508 in 2011.

The IMO says there is also ongoing concern about the extent to which benzodiazepines are implicated nationally in cases of problem drug use and deliberate self-harm.

A national auditing system, as recommended by a committee reviewing the use of benzodiazepines in Ireland, has recently been implemented nationally. It is hoped this will reduce the amount of drugs being prescribed.

The next set of figures on the drugs prescribed to Irish patients on medical cards in 2014 will be released in the Autumn. 

Over-dependence of drugs

Newest studies suggests that the effectiveness of drugs in the treatment of illnesses like anxiety disorders may have been overestimated, with concerns that drug companies have not been transparent enough in opening up drug trials to examination.

Dr Pradeep K Chadha, also known as ‘The Drugless Psychiatrist’, promotes the use of alternative therapies.

He told Newstalk.com that psychiatry is currently being practiced in Ireland as Emergency Mental Health treatment and warns we are overly-reliant on prescription medication, which treats the condition but does not solve the problem since imbalances in the body often arise out of trauma.

Dr Chada says patients often receive psychotropic medications without being evaluated by a mental health professional. Many people in Ireland visit their GP and may walk away with a prescription for an antidepressant or other drugs without being aware of other evidence-based treatments that might work better for them without the risk of side effects.

Tune in to Breakfast on Wednesday from 7-10am for a discussion on the over-prescription of drugs to treat mental health problems


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