How Patients Request Antidepressants Affects Physician Care

A study by University of California at San Francisco researchers shows that patients who approach physicians with a general interest in antidepressants are more thoroughly evaluated for depression than patients who request specific medications or merely describe depressive symptoms.

Eighteen actors trained to play patients visited 152 physicians, describing symptoms of either carpal tunnel syndrome and major depression or lower back pain and an adjustment disorder. The actors then requested a brand name medication, a general antidepressant or nothing.

Results showed doctors asked .8 more questions with a general request and .45 more questions with a brand-specifc request than when no request was made. They were also more likely to inquire about suicidal thoughts and behaviors, make a referral or suggest a follow-up visit when a general antidepressant was requested.

Suggested medical professor and internist Mitchell Feldman, MD, MPhil:

"It may be that physicians see a request for a general medication as an invitation for further discussion about the diagnosis and treatment options, whereas brand-specific requests may be heard as a consumer demand for medical services in response to emotional persuasion rather than high-quality information."

Read more: Patients' requests for antidepressants can influence physician evaluation of depression