May 27, 2007

Anti-depressants for medical-card holders cost State €40m

Publication: Sunday Independent

Date: Sunday, May 27, 2007 Page: 17

Author: Niamh Horan  

Headline: Anti-depressants for medical-card holders cost State €40m  

A consultant psychiatrist has estimated that 250,000 people are now taking anti-depressants here, writes IT is costing the State over €40m a year to supply Irish medical-card holders with free anti-depressants, according to official government figures. In 2005, a total of 176,123 medical-card holders claimed for the medication, costing the state €41,673,390, according to the Health Service Executive (HSE). The cost of supplying the drugs has risen nearly €4.5m from the previous year, indicating an increase in the number of Irish patients being prescribed anti-depressant medication. In 2004, the state spent €37,087,853 supplying medical-card holders with the drugs as part of the Medical Primary Care Reimbursement Service, a scheme which allows members of the public who satisfy certain criteria to avail of a range of services free of charge.  Meanwhile, the National Advisory Committee on Drugs (NACD) has reported that one in five Irish people have admitted taking sedatives, tranquillisers or anti- depressants during their life- time. The results were taken from the 2002/2003 all Ireland general population drag prevalence survey, which was carried out in conjunction with the Drug and Alcohol Information and Research Unit (DAIRU) in Northern Ireland. The report focussed on prescribed and unperceived sedative, tranquilliser or anti-depressant use in the adult population. It also found that, of that one in five, nearly half said they had used sedatives, tranquillizers or anti-depressants in the last month and 84 per cent of those were taking them on a daily basis. Use of the drugs was most prevalent among people aged over 35 years, or who were long-term unemployed, or who had left school at primary level.  

Geraldine Clare, Chief Executive of Aware says that despite the huge sums of money currently being spent on anti-depressants in Ireland, there is still a significant amount of stigma attached to medication which is being prescribed for mental illness. "Our experience would be that because of the stigmatisation of depression, people might be reluctant to go forward for help. Also, some times the range of treatments isn't available and this type of treatment [anti-depressants] is the only option. "I think people are less accepting of medication as a treatment for mental illness than they are of it for physical illness. They don't see the two in the same light." She added, "Overall we are less open-minded to drugs that treat depression than those that treat physical illnesses. There is ambivalence there, and that's not helpful for those who find themselves with the illness." Meanwhile, a prominent consultant psychiatrist has estimated that anything up to a quarter of a million Irish people could currently be taking anti-depressant medication.  

Dr Michael Corry, a consultant psychiatrist at the Institute of Psychosocial Medicine in Dun Laoghaire, says that over-the-counter sales are pointing towards an ongoing increase in consumption of the drugs in Ireland. "We know from pharmacies and over the counter sales, in other words the number of packets that are sold per year in Ireland, that a substantial number of people in this country are on anti-depressants. "Through information from the Intercontinental Medical Research Centre, we can estimate that between 200,000 and 250,000 packets of the medication are sold over the counter each year. And that doesn't factor in out-patients or even hospitals who are giving patients the medication." • He added, "The use of anti- depressants is rising at a rate of 10 per cent per year. People are under more pressure than ever before and it seems that many are finding it very difficult to make the necessary changes in their life."

However, the HSE argues that it is not possible to state the exact numbers of people who take anti-depressant medication.  A spokesperson for the service, Paul O'Hare, said, "The figure of 250,000 is consistent with the estimated number of people in Ireland who are suffering from depressive illness at any given time whether diagnosed or not." Clearly, people whose depressive illness is undiagnosed will not have been prescribed anti-depressant medication. Also, some people present with symptoms of physical illness such as stomach complaints or fatigue which may result from or be made worse by underlying, undiagnosed depressive illness. Anti-depressants for medical-card holders cost State €40m patients may not be prescribed anti-depressants either." He added, "Also, a small number of patients may be prescribed anti-depressant medication for the treatment of illnesses other than depression. Some medication typically used for treating depression has other therapeutic effects and is used to treat, for example, enuresis and facial pain."