By 2007, 73 percent of visits where an antidepressant was prescribed recorded no psychiatric diagnosis
"Between 1996 and 2007, the proportion of visits at which antidepressants were prescribed but no psychiatric diagnoses were noted increased from 59.5 percent to 72.7 percent."
Suggestive but preliminary. Not settled. how we score evidence
Caveat on this rating: Visit-level survey data: a diagnosis may exist in the chart from an earlier visit. Off-label but evidence-supported uses (pain, insomnia) are counted as "no psychiatric diagnosis". Data end in 2007.
Most people who start a psychiatric medication do not start it with a psychiatrist, and most of the time nobody writes down what it is for.
Significant findings
Mojtabai and Olfson (Health Affairs, 2011) analysed a national survey of office visits. Antidepressants had become "the third most commonly prescribed class of medications in the United States. Much of this growth has been driven by a substantial increase in antidepressant prescriptions by nonpsychiatrist providers without an accompanying psychiatric diagnosis."
"Between 1996 and 2007, the proportion of visits at which antidepressants were prescribed but no psychiatric diagnoses were noted increased from 59.5 percent to 72.7 percent."
The authors are careful: "These results do not clearly indicate a rise in inappropriate antidepressant use, but they highlight the need to gain a deeper understanding of the factors driving this national trend".
Worth asking
A missing diagnosis on a visit record is not the same as no reason. Antidepressants are used for pain, sleep, hot flushes and migraine, and a busy primary care doctor may not code the depression they are treating. But it means that for most new antidepressant prescriptions there is no recorded target, which makes it hard for anyone, including the patient, to say later whether it worked or when it should stop. If you are prescribed one, ask what it is for, how you will both know it is working, and when the plan is to review it. The data are from 2007; nobody has published the same analysis for recent years.
Source
Proportion of antidepressants prescribed without a psychiatric diagnosis is growing — Mojtabai R, Olfson M (2011)
Reputable peer-reviewed journal
Read the source: https://doi.org/10.1377/hlthaff.2010.1024
DOI: 10.1377/hlthaff.2010.1024
How this was scored
- Study design
- Cross-sectional study / survey
- Funding
- Independently funded
- Published in
- Reputable peer-reviewed journal
- Sample size
- not recorded
- Preregistered
- not recorded
- Conflicts disclosed
- not recorded
- Independent of proponent
- not recorded
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published September 21, 2026.
Questions
How strong is the evidence behind this?
veisund rates this source "early signal". Suggestive but preliminary. Not settled. It scores 52 out of 100 on our published rubric. One caveat travels with that badge: Visit-level survey data: a diagnosis may exist in the chart from an earlier visit. Off-label but evidence-supported uses (pain, insomnia) are counted as "no psychiatric diagnosis". Data end in 2007. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Proportion of antidepressants prescribed without a psychiatric diagnosis is growing — Mojtabai R, Olfson M (2011). Published in: Reputable peer-reviewed journal. DOI: 10.1377/hlthaff.2010.1024. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Cross-sectional study / survey. Funding: Independently funded. Independence from the proponent is not recorded. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.