Big demand for antidepressants

Subsidised prescriptions for antidepressants have jumped by nearly 20 per cent over the last six years in the Rotorua area.

Figures from the Government's drug-buying agency Pharmac show 31,000 prescriptions were issued in the Lakes District Health Board region last year, up from 26,000 in 2006.

As well as depression, antidepressants are often used to treat anxiety disorders, chronic pain and for smoking cessation.

Across the country, prescription rates have also jumped. In 2011, a total of 1,376,000 subsidised prescriptions were issued, 37 per cent more than in 2006.

Irene Begg, of Talkin Headz Counselling in Rotorua, said many of her clients had been prescribed antidepressants for trauma-related incidents.

"If I believe that their mood is severely low ... I would then refer them on to their doctor if I believed they needed antidepressants and [to] get a second opinion.

"If it's moderate or mild depression and it's purely situational depression - which could be [if] they've just lost their job ... or their relationship has broken down - I suggest they try a short course of St John's Wort [which] is a herb."

Ms Begg said antidepressants benefited people who had become severely depressed and were struggling with normal, everyday activities.

"If somebody is feeling depressed and down, first and foremost contact your GP.

"Sometimes they'll need something short-term, because often it is just short-term and it will come right."

However, Associate Professor of Psychiatry at the Waikato Clinical School, David Menkes, warned drugs were too readily available to patients. Doctors needed to be extremely careful in prescribing them, he said.

"On the one hand I would say there's probably too many antidepressant prescriptions being issued, but on the other hand because these drugs can be very useful for people who really can benefit from them - I wouldn't suggest their use be drastically curtailed.

"I think they ... need to be used perhaps just a bit more carefully."

One of the major issues with depression was that it was difficult to diagnose, he said.

There was a difference between someone feeling low because of an upsetting situation, loss or injury, and someone who was clinically depressed, which was more likely to be associated with impaired function, Dr Menkes said.

"The problem is that distinction has become blurred, partly because of the over-availability of antidepressants."

Dr Menkes recommended alternatives such as Cognitive Behavioural Therapy (CBT) be thoroughly explored before antidepressants were administered.

"The classic triad of cognitive depression is that you see yourself, the world and the future all in negative terms," he said. "What CBT aims to do is to specifically challenge those negative views and replace them with something more positive, and that in turn is meant to translate into a benefit to mood.

The therapy also involved getting people to plan for and schedule "pleasant activities".

"That's seeing friends, going to a film, going for a nice walk."