Some of the costs of prescribing antidepressant drugs over the last decade could have been used to deliver psychological treatments of proven effectiveness, finds a study published online by the BMJ today.

Prescribing of antidepressant drugs has risen dramatically in the United Kingdom since the early 1990s. Cognitive behaviour therapy is an effective alternative to drugs, but has not been developed for widespread use.

Using Department of Health prescribing data, researchers at the University of Bristol estimated the number of patients that could have been treated with cognitive behavioural therapy in 2002, had the rise in prescribing not occurred and the associated costs been diverted to psychological treatment and therapists.

Between 1991 and 2002, prescriptions per head for all antidepressants increased almost three-fold and the total cost (adjusted for inflation) increased by ?310m. These costs could have been used to deliver cognitive behaviour therapy to 1.54 million patients, more than a third of the adults in the UK with depression or mixed anxiety depression.

Despite some limitations, this analysis highlights the scale of resources expended in this area. The results indicate that development of psychological therapies is a feasible alternative to antidepressants, say the authors.

There is a clear need for further research to establish the most appropriate balance between drugs and non-pharmacological treatments for depression, they conclude.

Online First
(Opportunity cost of antidepressant prescribing in England: analysis of routine data)