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Psychiatric drugs in Australia - Who is taking What?
Australians are among the world’s highest users of psychiatric drugs. From July 2200 to June 2021, more than one in six Australians (4.5million+ patients being 17.7% of the population) were dispensed at least one mental health-related medication.
Antidepressants were easily the most commonly dispensed (3,503,862 patients), with the next most common being Anxiolytics (904,253), Hypnotics and Sedatives (618,952), Antipsychotics (493,850), and Stimulants (288,098).[1] Hundreds of thousands of patients were dispensed more than one type of psychiatric medication, however the actual number is unclear.
Despite the fact that they have limited psychiatric and neurological training the vast majority (84.7%) of prescriptions were made by general practitioners. Psychiatrists only prescribed 7.5% of the total number of scripts.
Older Australians were the heaviest users, with a staggering 41% of those aged over 84 years dispensed at least one psychiatric medication. Rates rose progressively through the older age groups (0-4 years 0.2%, 5-11 years 4.8%, 12-17 years 9.5%, 18-24 years 14.1%, 25-34 years 14.9%, 35-44 years 18.5%, 45-54 years 22.6%, 55-64 years 23.6%, 65-74 years 26.6% and 75-84 years 32.9%).[2]
A higher proportion of females (21.0%) than males (14.3%) received medication. Residents of Inner regional areas were dispensed psychiatric drugs at the highest rate (22.2%), followed by people in Outer regional areas (20.2%), Major cities (16.5%), Remote (14.9%) and Very remote (8.5%) areas.[3] Among the Australian states, Tasmania had the highest rate of psychiatric medication use (2.3 prescriptions per resident) and New South Wales had the lowest (1.51 prescriptions per resident).
These high rates of psychiatric drug use invite obvious questions: Are Australians benefiting from all this medication use? Or are Australians suffering from a harmful epidemic of psychiatric over-diagnosis and over-prescribing?
[1] Table PBS.2: Number of patients dispensed one or more mental health-related medications, by type of medication prescribed and prescribing medical practitioner, states and territories, 2020–21 Available at https://www.aihw.gov.au/mental-health/topic-areas/mental-health-prescriptions#data
[2] Figure PBS.3: People (per cent) dispensed one or more mental health-related medications, by patient demographics, 2020–21 https://www.aihw.gov.au/mental-health/topic-areas/mental-health-prescriptions#data
[3] See https://www.aihw.gov.au/mental-health/topic-areas/mental-health-prescriptions#summary
Depression, Antidepressant Use and Suicide in Australia
Although Australians rank highly in global happiness ratings, since at least 2000, we have been among the world’s biggest users of antidepressant. Between 1 July 2020 and 30 June 2021, more than 3.5 million Australians of all ages (13.0%) were prescribed an antidepressant.[4]
This included 137,111 Australian children (aged 0-17 years).[5] Through the COVID pandemic, these numbers have grown substantially, especially among young Australians. This is despite the fact that no antidepressant is approved by the TGA for the treatment of childhood depression and all antidepressants carry warnings that they increase the risk of suicidal thoughts and behaviours in depressed people aged under 25 years. Since 2008, the per-capita rates of the use of antidepressants and suicide and self-harm among young Australians have all risen alarmingly, raising concerns that the warnings have been ignored and young people have died as a result.
The vast majority of Australian antidepressant prescribing is done by general practitioners. Some critics contend that GPs lack the depth of mental health training of psychiatrists and psychologists. They contend that this, and other social and economic factors, that have resulted in an increasingly medicalised response to human suffering.
There are also growing concerns about both the efficacy and safety of antidepressants, and their withdrawal effects. Until recently, the dominant theory justifying the use of antidepressants, was that depression was caused by a ‘chemical balance’ involving serotonin. However, this theory has been discredited with many of the proponents and organisations (including the RANZCP) that claimed that antidepressants rebalanced brain chemistry, reluctantly acknowledging it this is wrong.
The role of antidepressants, and the medicalisation of depression, is undoubtedly among the most significant mental health controversies within Australia and globally.... Read more here.
[4] Table PBS.2: Number of patients dispensed one or more mental health-related medications, by type of medication prescribed and prescribing medical practitioner, states and territories, 2020–21 Available at https://www.aihw.gov.au/mental-health/topic-areas/mental-health-prescriptions#data
[5] Table PBS.5: Number of patients dispensed one or more mental health-related medications, by type of medication prescribed, sex and age group, 2020–21 Available at https://www.aihw.gov.au/mental-health/topic-areas/mental-health-prescriptions#data
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