National trends in long-term use of antidepressant medications: Results from the US National Health and Nutrition Examination Survey

Objective: To assess the trend in long-term use of antidepressants by persons aged ≥ 18 years, and the correlates of such use, in the United States from 1999 to 2010. Method: We examined trends in duration of antidepressant use and correlates of long-term use in data from 6 waves of the cross-sectional National Health and Nutrition Examination Survey (N = 35,379), a representative survey of the general population. Results: The overall prevalence of antidepressant use increased from 6.5% in 1999-2000 to 10.4% in 2009-2010 (odds ratio [OR] = 1.54; 95% CI, 1.31-1.81; P < .001). This included an increase from 3.0% to 6.9% in long-term use (≥ 24 months; OR = 2.12; 95% CI, 1.75-2.57; P < .001). Medium-term (6 to < 24 months; from 1.3% to 1.6%) and short-term use (< 6 months; from 2.2% to 1.8%) of antidepressants did not change appreciably in this period. The increasing trend in long-term antidepressant use was limited to adults who received their care from general medical providers (adjusted OR = 3.86; 95% CI, 2.57-5.80; P < .001). Conclusions: From 1999 to 2010, there was a marked increase in long-term use of antidepressant medications in the United States, explaining the overall increasing trend in antidepressant use. This trend calls for greater vigilance in prescribing antidepressants for long periods of time.