the public health impact of antidepressant medications

general population surveys often report that only a small proportion of individuals with common mental disorders seek mental health treatment, suggesting a high level of unmet need for mental health care in the community. in recent years, however, the number of adults in industrialized countries who are treated with antidepressant medications has dramatically increased. this paper reviews the public health impact of the increase in the use of antidepressant medications. whereas some studies suggest a decrease in the incidence of suicide corresponding with the increase in the use of antidepressant medications, other studies do not report such an association. furthermore, there has been no change in the period prevalence of common mental disorders concurrent with the increase in the use of antidepressant medications. focusing effort and resources on expanding the capacity of mental health services and improving access to these services without attention to quality, intensity and appropriate targeting of treatments may have limited impact on the mental health of populations.