Posted by dj on March 29, 2001, at 14:12:34
Visits to MDs for depression up 36%
- 7.8 million consultations in 2000 as illness loses its stigma and drugs lose side effects
Heather Sokoloff
National PostCanadians go to the doctor for depression more often than for any other ailment except high blood pressure, according to a report released yesterday.
Depression is the fastest-growing reason Canadians go to a physician, according to statistics released by IMS Health, an independent Montreal-based organization that tracks drug sales.
Its examination of annual prescription drug trends across the country indicate doctor visits for depression have jumped 36% in the past five years.
Doctors say more Canadians are seeking treatment for depression today because it no longer carries the stigma it did a 10 years ago.
"It used to be thought, if someone was depressed they showed a lack of psychological strength," said Dr. Pierre Bleau, a psychiatrist with the McGill University Health Centre in Montreal.
The survey results are no surprise to doctors like Dr. Bleau, who said the same number of people have probably always experienced depression: He estimated between 10% and 20% of Canadians experience it.
The difference now, according to Dr. Bleau, is that people are more willing to talk about depression because celebrities such as actor Drew Carey and television journalist Mike Wallace have publicly discussed their battles with the disorder.
The IMS Health study found Canadians had 7.8 million medical consultations for depression in 2000, up from 5.7 million in 1995, putting the disorder ahead of diabetes, acute respiratory infections, anxiety, ear infections, bronchitis and asthma among reasons for doctor's visits.
High blood pressure continues to be the No. 1 reason Canadians see a doctor, with more than 16 million visits last year. In 1995, depression was the fourth-ranked reason to see a doctor.
The figures also indicate a 63% increase in the number of prescriptions filled to treat depressive disorders since 1996, increasing at an average rate of 13% a year.
The report also found that Canadians bought nearly 291 million prescriptions last year, costing $11-billion. Canada is the seventh-largest market for pharmaceutical sales in the world. In 2000, Canadian sales averaged about nine prescriptions per person, with an approximate cost of $35.48 per prescription.
Psychotherapeutics, including antidepressants, were the second most frequently dispensed class of drug last year, behind cardiovascular drugs. The fastest growth in sales was anti-arthritics, which outpaced all other drugs with a 23% increase.
Treatments for depression have improved, say doctors, who are more willing to prescribe new drugs that have fewer side effects than treatments 20 years ago that left patients with dry mouths, insomnia, and a reduced sex drive.
"Family physicians are more aware, and have become attuned to detecting depression in their patients," said Robert Cooke, head psychiatrist at the depression clinic at Toronto's Centre for Addiction and Mental Health.
Drug companies, doctors say, have also aggressively promoted their products. The antidepressant drug Paxil is now the eighth most prescribed drug in Canada, with more than three million prescriptions in 2000, up 19% from 1999, according to the report.
Dr. Cooke said some patients may be taking medication they do not need. "They are not getting the chance to consider some alternative treatment that might be just as good for them." Still, doctors say far more people remain undiagnosed and untreated for the disease.
"Even though it sounds striking that we have this big raise in the number of consultations, from my understanding this is an improvement. Depression is not a trivial thing. It needs a good evaluation and good treatment," said Dr. Bleau, adding the suicide rate for patients with depression is 20%.
The IMS Health report found almost half of those seeking treatment for depression are aged 40-59, while 31% are aged 20-39.
Doctors say many in these groups must deal with the combined pressures of young children and ageing parents. This is also an age group that is susceptible to life-threatening diseases, and doctors say a diagnosis of cancer can also lead to a case of depression.
Among seniors who outlive friends and relatives, the risk for depression is high, said Barry Hall, vice-president of the Canadian Association for Suicide Prevention.
Among the other findings, the Canadian market was the second-fastest growing, with a 16% increase over 1999 sales. Only Mexico grew at a faster rate.
In terms of sales, Losec, a drug for peptic ulcers, remained Canada's top-selling drug last year. It is also the world's best-selling drug. The most commonly dispensed drug in Canada in 2000 was Synthroid, which treats hypothyroidism.
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