The Last Psychiatrist has an interesting essay and commentary about a study published last week in The New England Journal of Medicine. He focuses not so much on the results of the study, which found that adding an antidepressant to existing bipolar medications didn’t much help anyone.

The Last Psychiatrist focuses on the fact that the term “mood stabilizers” now goes well beyond lithium and Depakote:

What’s happened here is that “mood stabilizer” now includes atypical antipsychotics; and — compare what the study was designed to show and what they spun it to show — we’ve gone from “polypharmacy is not better” to “monotherapy with mood stabilizers [read: antipsychotics] is just as good as two drugs at once.” [...]

What the article is saying is that academic psychiatrists are no longer behind antidepressants and antiepileptics. SSRI and SNRI use will decline from here, as will Depakote. They’re behind antispychotics. And antipsychotic use is positioned to explode.

It goes without saying: only the antipsychotics are still branded.

I’m not sure how much truth there is in this assertion, but time will certainly tell.

For the record, though, I will note there are still plenty of patented, branded antidepressants on the market, and I see no decline in new ones in the pipeline. I don’t think we’ll see the predicted trending move toward greater diagnosis of bipolar disorder over that of depression. They are distinct disorders.

Many clinicians who do the diagnosing (think psychotherapists and psychologists) don’t care about medication treatment nearly as much as their physician counterparts do. Treatments available never entered into my diagnostic picture because, like most therapists, diagnoses are made based upon symptom constellations, not what we can do about them.

So the answer to my question is, “No, depression diagnoses will not start to wane.” Depression is still an undertreated concern and probably still underdiagnosed because of the stigma still associated with it.

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

Like this author?
Catch up on other posts by John M. Grohol, PsyD (or subscribe to their feed).

Comments

This post currently has 3 comments. You can read the comments or leave your own thoughts on our new comments page.

Trackbacks

No trackbacks yet to this post.

    Last reviewed: By John M. Grohol, Psy.D. on 11 Apr 2007
    Published on PsychCentral.com. All rights reserved.