With questions about the safety and efficacy of antidepressants given fresh impetus by a recently published clinical trial and a repeat blast of controversy over the availability of suicidiality data on GlaxoSmithKline’s Seroxat (paroxetine), a US study suggests that treatment strategies in that country may be targeting the wrong people.

Ramin Mojtabai from the Department of Psychiatry at Beth Israel Medical Center in New York looked at trends in the prevalence of antidepressant drug treatment over a 12-month period in two US general population surveys, the US National Comorbidity Survey (1990-1992) and the National Comorbidity Survey – Replication (2001-2003). Variations in trends across sociodemographic groups were examined using bivariate and multivariate regression models.

Reporting the findings in Psychotherapy and Psychosomatics (2008;77:83-92), Mojtabai said the rate of antidepressant drug treatment in the US surveys had more than quadrupled between the early 1990s and the early 2000s. This trend was similar across sociodemographic categories.

However, younger adults, men and racial/ethnic minorities continued to be prescribed antidepressants at a lower rate than middle-aged adults, women and non-Hispanic whites respectively. And the rate of antidepressant treatment rose more sharply in less severely ill individuals than in those with more severe psychopathology.

Mojtabi concluded that sociodemographic disparities in antidepressant treatment had persisted over the last decade in the US, “lending support to concerns about undertreatment among traditionally underserved groups, whereas the greater increase in the rate of antidepressant treatment in the less severely ill group lends support to concerns about antidepressant overtreatment in this population”.