Article Review: National Patterns in Antidepressant Medication Therapy

           I have chosen to read and review an article entitled National Patterns in Antidepressant Medication Treatment. This article was written by Mark Olfson, MD, MPH and Steven C. Marcus, PhD. The article was in the August 2009 issue of the Journal of General Psychiatry. This article examined the trends in antidepressant use in the years 1996 and 2005.

            Antidepressants have become the most commonly prescribed class of medications in the United States, surpassing antihypertensive agents in 2005. In 2001 – 2003, 20.1% of nonelderly adults received mental health treatment each year. This was an increase from the 12.2% in 1990 – 1992. The sources of data used were the 1996 and 2005 Medical Expenditure Panel Surveys (MEPs). These surveys asked for all prescribed medicines associated with each health care as well as the reason for each outpatient visit during the reference period. The reported psychotropic medications were then classified into three different classes. These classes were 1) antidepressant, anxiolytic, or antipsychotic, 2) mood stabilizers and 3) stimulants. Each of these three classes had subclasses. Between 199 and 2005, the overall annual rate of antidepressant treatment of persons 6 and older, increased from 5.84% to 10.12% per 100 persons. This translates to an increase from 13.3 million people in 1996 to 27.0 million in 2005 that are treated with antidepressants. During this period, the use of serotonin reuptake inhibitors and other newer antidepressants became increasingly common; whereas tricyclic antidepressants became less common. There was an increase in percentage of antidepressant users treated with antipsychotic medications, but a decrease in percentage of those who received inpatient treatment of psychotherapy. Of the persons prescribed antidepressants in 2005, 34.59% treated by psychiatrists and 7.46% treated by non psychiatrist physicians were also prescribed mood stabilizers or antipsychotic medications.

            In conclusion, there was a significant increase in the percentage of Americans prescribed antidepressants. Also, the study performed may be inaccurate due to several reasons. The data collected in the MEPs may be inaccurate. Another reason is that it is uncertain if all persons prescribed antidepressants met the criteria for diagnosis. Third, some groups of individuals such as homeless, nursing home residents, and inmates are not included in the surveys. Fourth, there may be incomplete information in the MEPs. These studies show that antidepressant therapy is becoming more accepted in the United States. It also shows that there is more focus on pharmacological treatment rather than psychological care.

Works Cited

  Olfson, M., & Marcus, S. (2009; 66 (8)). National Patterns in Antidepressant Medication Treatment. General Psychiatry , 848-856.

.Plagiarism:

Using someone else's work without giving proper credit, is plagiarism. If you use my work, please reference it. 

Steroids and Their Effects

During World War II, it was discovered that malnourished people could gain weight if they took the male hormone, testosterone. The Soviets were the first to use it for their athletes. During this time the disadvantages were the masculinizing effects on women and the enlargement of the prostate gland in men. An American physician then helped develop and test anabolic steroids, which promoted constrictive metabolism.

            Steroids have androgenic, or masculinizing, effects. These include growth of the penis and other male sex glands, deepening of voice and increased facial hair. Steroids also have anabolic effects which include increased muscle mass and strength and increased size of some internal organs. Other anabolic effects are that it controls the distribution of body fat, increases the building of proteins and increases the calcium in the bones.

            Steroids give a user a stimulant - like high. They can also increase aggression. A drawback of steroid use is the psychological dependence. The user feels good while on steroids, but depressed when off of them. A steroid user can also experience mood swings which can interfere with personal and even professional relationships. A major drawback of steroid use is the manic rage that has come to be known as “roid rage”. Roid rage is under discussion as a legitimate effect and bears having research done. Users that suffer from roid rage describe having violent feelings and actions, which are sometimes uncharacteristic of them.

            Steroids also have physical effects. Steroids can increase the amount of work a user can do and increase the intensity of effort. For younger users who have not reached their full height, steroid use can cause premature closing of growth plates thus limiting adult height. Another physical effect is peliosis hepatitis, which is a bloody cyst in the liver. Steroid use can also affect your cardiovascular system. Such effects are atherosclerosis (thickening of artery wall as result of a build – up of fatty materials), high blood pressure and heart disease. Acne, baldness, partial or complete wasting away of the testes and breast enlargement are all possible effects seen by men. Women have a low dose of testosterone naturally. When steroids are taken, some women experience muscle growth, mild acne, decreased breast size, fluid retention, enlargement of the clitoris, facial hair and deepening of voice. Some of these effects are irreversible.

            When weighing the advantages and disadvantages of steroid use, I must admit that I cannot find one single advantage worth all the disadvantages. I think I can handle gaining strength and endurance the old fashioned way rather than risk any of the negative effects.

References

Hart, C.L. & Ksir, C. (2011). Drugs, Society & Human Behavior (14^th ed.). New York, NY: The McGraw – Hill Companies, Inc.

.Plagiarism:

Using someone else's work without giving proper credit, is plagiarism. If you use my work, please reference it.