5m drug prescriptions for mental health a year

MORE than five million prescriptions for powerful drugs to treat depression, psychosis, anxiety or lack of sleep are being written every year, costing in excess of €110 million, official figures have revealed.

The true extent of so-called “pill-popping” in Ireland, however, is much more as the only figures recorded are for medical card holders and people claiming through drug payment schemes, which accounts for less than half the population.

Figures compiled by the Irish Examiner from the HSE’s 2009 Primary Care Reimbursement Service show 14,000 prescriptions for anti-depressants, benzodiazepines (addictive tranquillising pills), anti- psychotics and sleeping tablets were being written every day, at a cost of €113m. The drugs are now being prescribed as often as common antacid tablets.

A report in 2002 found 11.6% of the adult medical card population were using benzodiazepines.

Since that report, the prescribing of Valium and Xanax, both used to treat anxiety and panic, have increased dramatically, with 399,798 prescriptions written for Xanax in 2009, compared with 283,000 in 2005.

The Mental Health Commission, during the inspections of 2010, found the use of benzodiazepine in both acute and long-stay units was widespread. In total, 57% of in-patients were prescribed benzodiazepines. Of these, 62% were on regular doses of the highly addictive drugs.

Nine anti-depressants, most of which are selective serotonin re-uptake inhibitors (SSRIs), were prescribed more than 2.2 million times in 2009.

Basil Miller, director of communications at the Wellbeing Foundation, said it is clear from the data that anti-depressants are grossly over-prescribed.

“This is largely down to inappropriate prescribing, where anti-depressant scripts are written as first recourse for depression when all the guidelines state that they are not to be used as a first treatment for depression and are not appropriate for mild to moderate depression.

“Because counselling and talk therapy, which work better for depression, are not widely available in the general medical service and are costly in private practice, pills are prescribed which should not be prescribed,” he said.

“Virtually everyone who presents with depression gets a pill. As severe depression is diagnosed in only 5% of cases, this means that 95% of patients are being given anti-depressants contrary to guidelines.

“If the guidelines were followed, the bill for anti- depressants would be €3m, not €60m. It’s time to spend that €57m on talk therapies which work, rather than lining the pockets of the drug companies by paying for the wrong — and ineffective — treatment.”

In relation to anti-psychotic drugs, usually prescribed for schizophrenia, bipolar disorder or to manage psychosis, former mental health inspector Dr Dermot Walsh maintains that second generation anti-psychotics — such as the current most commonly prescribed olanzapine (better known as Zyprexa) — cause “substantial adverse effects”, compromising life expectancy in psychiatric patients.

Dr Walsh said that there is emerging evidence that some changes in the structure of the brain, previously thought to be the consequence of the schizophrenic process, may actually be treatment-related.

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