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Anxiety -- and anxiety drugs -- on the rise

Reflecting the tremendous growth in the use of antidepressants, nearly 80% of people seeking treatment for depression or anxiety were prescribed antidepressants, according to a recent survey of Consumer Reports (CR) subscribers. However, the report reveals that the drugs were no more effective that traditional "talk therapy."

The report also found that anxiety itself is on the rise. Of the 1,500 subscribers seeking treatment, 58% had experienced anxiety, up from 41% in 2004 when CR last surveyed subscribers about these conditions.

The 2009 survey provides a window into how mental-health treatment is practiced in the real world and how it's become as drug-oriented as physical medicine.

The survey found that older, often less expensive antidepressants known as SSRIs (selective serotonin reuptake inhibitors) like Lexapro, Celexa, Prozac, and Zoloft work just as well, and with fewer side effects, than newer, more costly drugs known as SNRIs (serotonin and norepinephrin reuptake inhibitors) like Cymbalta and Effexor. SSRIs and SNRIs address depression by altering the levels of certain brain chemicals.

When asked to rate antidepressants, 53% of respondents taking SSRIs said they helped "a lot." SNRIs fared no better, with only 49% reporting they helped "a lot." However, both drugs produced side effects ranging from sexual dysfunction and weight gain to sleep problems.

Drug-free "talk therapy" ranked much higher than both: 91% said therapy made things "a lot" or "somewhat" better.

The report emphasized that with talk therapy there are no drug side effects and it can be used over the long term, two clear advantages over medication. It received high marks from CR's survey participants. Those who stuck with talk therapy for at least seven sessions scored as high as people treated mostly with medication on an overall outcome scale.

Despite the lack of effectiveness compared to drug-free approaches, drugmakers spent almost $300 million in 2009 on ads for two newer antidepressants: duloxetine and desvenlafaxine. "Pharmaceutical companies stand to profit most from convincing consumers that drugs are the only answer to depression and anxiety, and that newer, more expensive drugs are a better alternative to older drugs and their generic counterparts," said Nancy Metcalf, senior program editor, Consumer Reports Health.

The report is available in the July issue of Consumer Reports.

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