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Roy H Perlis, Anudeepa K. Ramachandiran, Pilar Verhaak | BMJ Mental Health | (2026)
Primary Link Pubmed DOI Openalex Full text (OA)

Key Takeaways

Plain English Takeaway

Many adults in the US use antidepressants or therapy, but not everyone has the same access. Most people do not want new rules that would make it harder to get these medicines.

Study Aim

The study set out to measure how many American adults currently use or have ever used antidepressant medications and psychotherapy (talk therapy). It also aimed to find out how people feel about possible new federal rules that could make it harder for doctors to prescribe antidepressants. The researchers wanted to see if these patterns and opinions differ by age, gender, race, ethnicity, and other background factors. Simply put: The study wanted to know who uses antidepressants and therapy in the US, and how people feel about making it harder to get these medicines.

Study Design

The researchers conducted a cross-sectional survey, which means they collected information from people at one point in time. They used an online survey panel that included 30,810 adults from all 50 US states and the District of Columbia. The survey was designed to match the US population in terms of age, gender, race, ethnicity, education, region, and whether people live in cities or rural areas. Participants answered questions about their use of antidepressants and psychotherapy, their attitudes toward possible federal restrictions on antidepressant prescribing, and their political affiliation. The researchers used statistical models to see how different background factors were linked to treatment use and opinions. Simply put: The study asked a large, diverse group of adults across the US about their use of antidepressants and therapy, and their views on new rules for these medicines.

Findings

The study reveals that 16.6% of respondents were currently taking antidepressants, and 10.4% were in psychotherapy. More White and non-Hispanic people used these treatments compared to other racial and ethnic groups. Men were less likely than women to use antidepressants or therapy, while transgender and nonbinary people were more likely to use them. When asked about possible federal rules to limit antidepressant prescriptions, 48% opposed such restrictions, while only 16.4% supported them. People who had used antidepressants or therapy in their lifetime were much more likely to oppose restrictions. The study suggests that making it harder to get antidepressants would not match what most people want and could make existing gaps in mental health care even worse. Simply put: The study found that many people use antidepressants or therapy, but not equally, and most do not want new rules that would make it harder to get these treatments.

Abstract

BACKGROUND: Antidepressants are among the most prescribed medications in the USA, yet challenges in access to mental health treatment persist. OBJECTIVE: To assess current and lifetime antidepressant and psychotherapy use among American adults, and examine attitudes towards potential federal restrictions on antidepressant prescribing. METHODS: We conducted a cross-sectional survey study using data from a national non-probability internet-based panel weighted to approximate national demographics (age, gender, race and ethnicity, education, US census region, and urbanicity) based on 2020 US Census data. Data were collected between 10 April and 27 May 2025 from 30 810 adults residing in the USA. The primary outcomes were self-reported current and past antidepressant and psychotherapy use, and support for or opposition to potential federal restrictions on antidepressant prescribing. Logistic regression models estimated demographic and treatment-related features associated with these outcomes. FINDINGS: Among 30 115 respondents with complete antidepressant data, 16.6% reported current antidepressant use, and of 30 098 respondents with psychotherapy data, 10.4% reported current psychotherapy. Use of both treatments was significantly greater among White respondents compared with all other racial groups. When asked about potential federal restrictions on doctors prescribing antidepressants, 16.4% of respondents supported and 48.0% opposed such regulation, with lesser opposition among those of male gender (OR 0.69, 95% CI 0.65 to 0.73), and greater opposition among those with lifetime antidepressant treatment (OR 2.37, 95% CI 2.21 to 2.54). CONCLUSIONS: Antidepressant and psychotherapy use remains unevenly distributed across demographic groups. A significant proportion of adults in every US state oppose efforts to restrict access to antidepressant prescribing, reflecting broad public support for maintaining access to treatment. CLINICAL IMPLICATIONS: Findings from this study suggest that restrictive policies on antidepressant prescribing are unlikely to align with public sentiment and may risk exacerbating existing inequities in care.

Referenced In

Lee Johnson
a month ago
A Scientific Review of Claims made by RFK Jr.

Claim: Psychiatric Medications are “Overprescribed” in the US

Verdict: Likely inaccurate, and highly misleading.

“Today, we take clear and decisive action to confront our nation’s mental health crisis by addressing the overuse of psychiatric medications—especially among children”

WTAS: HHS Launches MAHA Action Plan to Curb Psychiatric Overprescribing

This week, RFK Jr. and his Department of Health and Human Services announced a plan to curb “overprescribing” of psychiatric medications, with a particular focus on youth.

Ignoring more outlandish previous statements made by RFK Jr. on this topic, the key issue here is simple: are psychiatric medications “overprescribed” in the US?

What is “Overprescribing,” Anyway?

“Overprescribing” refers to people being prescribed a treatment that they didn’t technically “need,” likely because other, non-medication approaches would have been effective.

This is a legitimate issue, but it should be immediately clear that this is a decision that can only realistically be made on a case-by-case basis by a qualified healthcare provider. Simply looking at rising prescriptions for psychiatric medications is not enough to say there is “overprescribing.”

Prescription vs. Prevalence Rates for Psychiatric Conditions

Although we can’t definitively prove or disprove overprescribing with less granular data, we can still broadly address it. If prescriptions broadly move with the prevalence of the condition, widespread overprescribing is unlikely.

One study from 2018 tackled this exact issue, for stimulants, antipsychotics and antidepressants prescribed to young people. The study found that prescriptions for antidepressants and stimulants are broadly in line with the underlying rates of ADHD, depression and anxiety. For antipsychotics, it’s harder to estimate due to off-label medication use, but it also seems in line with prevalence estimates.

More recent data shows a continued increase in depression prevalence, so it would be expected that prescription rates would continue to increase.

Overprescribing or Underprescribing? It Depends Where You Look

Other data reveals another fundamental issue with the logic here. Rates of antidepressant prescriptions vary drastically by demographic group, as shown in the attached image. Should we conclude that antidepressants are underprescribed among men but overprescribed among non-binary people?

The reality is that a complex interplay of factors influences prescribing. Simply reducing this to “psychiatric medications are overprescribed” ignores between-group differences, the changing need for psychiatric medications and the overall reality that many people with mental health issues don’t receive any treatment at all.

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