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Family doctors prescribe rash antidepressants

drugs are useful in the treatment of Depression are sometimes unavoidable, you can be Affected a great help. At the same time, you are no longer in the criticism because of the often limited efficacy and because of the strong increase in the number of prescriptions. A large analysis of the respected research network the Cochrane, which also took into account unpublished data showed in July that antidepressants work very well.

Exact Numbers of who writes like antidepressants frequently, in Switzerland, on the prescription pad, there exist only since recently. Therefore, 8.7 percent of the population is prescribed within one year of such drugs. Women receive twice as many antidepressants, which reflects the gender ratio in the diagnostics. In adults 45 to 74 years, the percentage is 12.5 percent. The value continues to rise in elderly patients and is of 85, almost one-quarter. A high proportion, which is problematic, as a just-published analysis confirms.

"The more friction, as would be expected," says Birgit Watzke, Professor of Clinical psychology at the University of Zurich and co-author of the study. "We are, therefore, of a deficiency of depressive patients." The study appeared in the Public little noticed, last summer in the journal "BMC Psychiatry". It is based on billing data from the year 2016, the health insurer Helsana, where about 13 percent of the Swiss population are insured.

The preparations are simple and quickly available in

A major cause for many of the regulations places the researcher at the primary care providers: According to the study, half of the patients received more than your prescription from a doctor. Psychiatrists prescribed only in 17 percent of all cases. The Rest fell on other specialty physicians, hospitals, or a combination of different suppliers.

Birgit Watzke has understanding for the Situation of the family doctors: "you want to offer your patients and prescribe antidepressants, because they are easily and quickly available," she says. Psychotherapy is elaborately quiet Elevator and had to be carried out by a specialist. Added to this are often wait times for those who actually need help quickly. In order to support the primary care in the treatment, have Watzke and colleagues called the specialist Department of Mental health to life.

"antidepressants have, in particular, in the case of mild depression no placebo effect beyond effect." Birgit Watzke, a Professor of clinical psychology

How big is the failed supply with antidepressants is, in fact, has not examined the study. It can only be estimated: "In Switzerland, approximately 8 percent of the population suffer in the course of a year, suffering from depression, of which, with proper treatment, but less than half of antidepressants should be given," says Watzke. Added to this are other problems such as forced and anxiety disorders for which the drugs are also used. "If these are added, there still remains a substantial proportion of patients treated with antidepressants fail," says the clinical psychologist.

For a problematic finding: "antidepressants have, in particular, in the case of mild depression no placebo effect beyond effect and often severe side effects."

Because it is recommendations Switzerland has no own treatment, based Watzke on your estimate on international guidelines, including those of the German society for psychiatry and psychotherapy, psychosomatics and nerve medicine. These are based on the relevant scientific literature and are developed in a complex process, with a representative panel of experts and stakeholders.

"The guidelines are formulated this more carefully," says Watzke. In accordance with the guidelines for psychotherapy for mild Depression in General, or a guided Form of self-help displayed. In the case of moderate severity antidepressants may be used if patients prefer psychotherapy. "If patients can choose, they decide mostly against antidepressants," says Watzke. In the case of severe expression, if possible, should be treated with medication and psychotherapy at the same time.

antidepressants for pain disorders

However, not all experts agree on how to interpret the Helsana study. Erich Seifritz, Medical Director at the Psychiatric University clinic in Zurich, the number of prescriptions in any case, not surprisingly: "it is in the range in which other European countries are moving." He assumes that Doctors prescribe antidepressants, in principle, correct. Often, the medications would be used also in diseases outside of the depressive spectrum, says the psychiatrist. In particular, in the case of sleep disorders, pain syndromes, perimenstruellen discomfort or stress incontinence. "This wide area of application and the frequency of prescription," says Seifritz explain.

Watzke, however, is not obvious that the prescription of antidepressants is something wrong. The show, in the study of the big Differences between the cantons: Basel-city, 11.9 percent received the prescription, in the Canton of Zug 6.5 percent. "This is not medically explain," says Watzke. The Same is true for the observation that patients with high franchises or Managed Care (family doctor model, HMO) received less antidepressants than others.

For the psychology Professor, there is in particular no reason why patients with increasing age should get a lot more common antidepressants. "That in the case of Elderly frequent bouts of depression occur, explains the massive differences is not sufficient," she says. In old age, it would be important antidepressants only economical to make. Because the patients have often already taking multiple medications, increases the risk of dangerous interactions and side effects with each additional pill.

Created: 25.11.2019, 19:18 Uhr

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