OBJECTIVES

There is a significant increase in prevalence of depression among adults, making it one of the most common mental health issues in the US. The aim of the study is to understand the subsequent utilization of anti-depressants in the US population from 2005-2016, based on the severity of depression and the patient characteristics.

METHODS

This study used the US National Health and Nutrition Examination Survey (NHANES) 2005–2016 data to provide a population-based estimate for the prevalence of depression and utilization of antidepressant drugs. The Patient Health Questionnaire (PHQ-9) was used to define (PHQ-9 score ≥10), and categorize depression into three severity levels – moderate (PHQ-9 score 10-14), moderately severe (15-19) and severe (20-27). Patients with at least one prescription medication in the last 30 days were included in this study.

RESULTS

A total of 2,584 participants were identified with depression. Of these, 1,658 patients had taken at least one prescription medication. The prevalence of depression increased significantly in the US from 5.4% to 7.4% during the period 2005-2016, while the severely depressed patients showed a two-fold increase from 0.4% to 0.9%. Likewise, the utilization of anti-depressant drugs has increased from 44.6% (95% CI: 35.5%-54.0%) to 57.4% (95% CI: 49.8%-64.8%), showing an increment of 30% (p-value: 0.0001) at overall level. Drug utilization among males increased by 53% (p-value: 0.0001), among non-Hispanic by 32% (p-value: 0.0001) and in >400% federal poverty line population increased by 54% (p-value: 0.0001). Among the anti-depressant drug classes, there was 69% increase in the use of SSRIs and 23% increase in SNRIs usage. Not much change was seen in the usage of atypical anti-depressants.

CONCLUSIONS

The analysis exhibited a significant increase in the utilization of anti-depressants among depression patients who were on prescription medication, during the last decade.