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Depression is life-threatening when severe, and debilitating when symptomatology is mild to moderate. It is also unfair, striking women nearly twice as often as men. The only good news about depression is that it is eminently treatable, especially if pharmacists and other healthcare providers stay alert to its symptoms. More than 19 million Americans suffer from depression, including about 12% of all women. But that unsettling fact is offset by the reality that about 80% of depressed patients improve with treatment.
Depression is strongly linked with other illnesses, such as heart disease and osteoporosis-diseases that women are at high risk for developing. Studies by researchers at the Emory University School of Medicine in Atlanta found that women experienced more symptoms of depression in the year following a heart attack or chest pains. "We found that the prevalence of depression is high in younger women with myocardial infarction," said Emory Heart Center scientist Viola Vaccarino, M.D., Ph.D., who headed the study. The findings of the study were published in an article titled "Patients with Depressive Symptoms Have Lower Health Status Benefits After Coronary Artery Bypass Surgery" in the Jan. 25, 2005, issue of the American Heart Association's journal Circulation.
The last large study of the extent of depression in this country was published in the June 18, 2003, issue of the Journal of the American Medical Association (JAMA) as "The Epidemiology of Major Depressive Disorder." The study involved 9,000 randomly selected people and was only the second nationally representative sample of depression ever conducted, said lead author, Ronald C. Kessler, Ph.D., professor of healthcare policy at Harvard Medical School. "Over half the depressed people surveyed had severe depression, and only 10% were considered mild to moderate," said Kessler. "Yet just one in five received adequate treatment. We found that less than half of them were getting even minimal treatment."
Pharmacists can help with all this, experts contend. If they familiarize themselves with the symptoms of depression, they can improve drug therapy outcomes, lower healthcare costs, and reduce the risk of suicide among depressed patients. So said Patrick Finley, Pharm.D., an associate professor of clinical pharmacy at the University of California San Francisco school of pharmacy. "At least 10% and as many as one in five people who walk into a pharmacy are depressed and not adequately treated, or treated not at all," Finley added. "When research shows that only about half of depressed patients are getting any therapy and only about 22% of all depressed patients are adequately treated, there is obviously a huge need that pharmacists can help fill."
Pharmacists are frequently the first clinicians women see when they have a health problem, according to Michael W. Jann, Pharm.D., professor at Mercer University Southern School of Pharmacy in Atlanta, so they should "embrace their responsibilities as providers to optimize clinical outcomes of patients with depression. They should be aware of the symptoms of depression especially common in women, he noted, such as the possibility of depression when patients complain of persistent, unexplained physical symptoms, such as fatigue or appetite changes, or when individuals repeatedly come into the pharmacy for nonprescription sleeping pills or pain relievers.
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