Almost 80% of antidepressants are prescribed by non-psychiatrists—and almost three-quarters of these prescriptions aren’t accompanied by a formal psychiatric diagnosis, Psych Central reports.
Perhaps that sounds like cause for major alarm, but let’s remember that a) primary care doctors may not be psychiatric specialists, but they’re not clueless either, and b) many people don’t have access to, or can’t afford, specialized psychiatric care. For the uninsured, being able to get anti-depressants during a physician visit could be a godsend; even those with insurance may find the added expense of psychiatric care too much (especially if they’re under a plan without good mental health coverage).
And what if you just plumb can’t get to a psychiatrist at a given time, but have a primary care physician you really trust? I started taking anti-depressants for the first time a couple of years ago, just before moving from Washington, D.C. to Brooklyn. The psychiatrist I saw wrote me a prescription after a dry, half-hour standard intake session (hardly time to really ‘get to know’ me or my mental health makeup), and insisted on writing me one-month prescriptions at a time. So I went to my family doctor while I was visiting home between cities; he wrote me a several-month prescription so I wouldn’t have to discontinue the meds (a notoriously bad idea) while I was in the midst of moving and getting settled in a new place. My family doctor has known me for most of my life—is he less-qualified to recommend anti-depressants for me than someone who’s known me for all of 30 minutes?
I’m not saying this is always how these situations play out—I’m sure there are many people prescribed psychiatric drugs by non-psychiatrists who hardly know them, their needs, or their medical histories. And maybe these non-psychiatrists are apt to miss crucial mental health signals pointing to problems beyond depression. In rare cases, this could be quite dangerous—for instance, in some bipolar individuals, SSRIs like Prozac can actually trigger manic spells. And we’ve all heard how anti-depressants can actually increase suicidal tendencies in some. But even though I’m just speculating here, obviously, this seems like a much more rare situation than someone who could benefit from antidepressants not being able to get them except through a non-psychiatrist. And it’s not exactly as if psychiatrists never mis-diagnose patients or prescribe psychiatric drugs that have unintended effects. What do you think? Take our poll, or sound off in the comments section, y’all.
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