Psychotherapeutic Drug Use Declines, While Antidepressant Use Continues to Rise
Updated
More than one-third of adults (34.2%) and more than one-sixth of adolescents (18.1%) are on psychotherapeutic drugs or have been prescribed these drugs within the last year, according to the latest Substance Abuse and Mental Health Services Administration (SAMHSA) numbers for 2025, which is a slight decrease from 2024. This includes pain relievers (mostly opioids), tranquilizers, stimulants, and sedatives. 4.6% of all adults and 2.4% of all adolescents misused these drugs within the last year. The data does not include people taking antidepressants like SSRIs and SNRIs.
The information came from the 2025 National Survey on Drug Use and Health (NSDUH), which involved self-reported responses from more than 60,000 people. Adult use dropped from 35.8% to 34.2% from 2024 to 2025, and adolescent use dropped from 19.5% to 18.1%.
“Today’s release represents the earliest release of NSDUH to the public in the survey’s history, reflecting SAMHSA’s commitment to advancing gold-standard science and data-driven policy, program, and practice innovation,” said SAMHSA Principal Deputy Assistant Secretary Christopher D. Carroll. “Building on encouraging trends first reported in the 2024 NSDUH, in 2025, adolescents aged 12 to 17 and young adults aged 18 to 25 continued to show downward or stable trends in most behavioral health indicators over the past five years.”
The numbers declined from the previous year, but that also is part of a longer downward trend dating back to 2015 since the NSDUH survey started tracking overall usage of pharmaceutically prescribed psychotherapeutic drugs. In 2015, 44.5% of all people above 12 years of age in the United States took psychotherapeutic drugs within the last year. About one out of six, or 7.1% of the population, misused these drugs.
A 50-state survey published in January found 16.6% of more than 30,000 respondents reported current antidepressant usage and 10.4% reported current psychotherapy. Antidepressant usage was 13.2% among adults in 2015-2018 according to NHANES data.
Drugs are the number one option chosen for people who are diagnosed with depression, even though there are several problems with this approach. The University of Michigan and Harvard conducted a cost-effectiveness analysis in 2019 that found that antidepressant drugs are much less expensive and thus more accessible to patients seeking treatment.
The researchers note that a majority of people would prefer to seek cognitive behavioral therapy (CBT) instead of taking pharmaceutical drugs to treat depression, but only about one-quarter of them actually receive therapy. The demand for CBT exceeds the current and projected number of psychiatrists and psychologists to guide the therapy sessions.
“One might assume that antidepressants are more cost-effective than psychotherapy, because they don’t require travel time, time away from work, and as many contacts with providers as therapy does,” says first author Eric L. Ross, M.D., a psychiatrist at Harvard Medical School, Massachusetts General Hospital, and McLean Hospital. “But when incorporating the long-term effectiveness of each treatment, we found that neither treatment is consistently superior to the other.”
The researchers found that antidepressant drugs are cheaper for patients than psychotherapy after the first year, but there are notable concerns with taking the drug-only approach. Patients often need to try many different drugs before finding one that seems to work for them, and they can experience a number of side effects along the way. Psychotherapy doesn’t come with the notable side effects that antidepressants are known for, which include lack of energy, nausea, erectile dysfunction, blurred vision, tremors, and more serious side effects like suicidal thoughts, serotonin syndrome, and stomach bleeding.
HHS announced a new strategy and framework in May to reduce the overprescribing of psychiatric medications. As much as 30-50% of antidepressant users have no evidence-based indication to continue. Specifically, Secretary Kennedy pointed to a lack of training for medical professionals to help wean patients safely off antidepressant drugs.
The New York Times ran an opinion column last week detailing the story of a man, named Cameron, in his mid 30s who has been on antidepressants for 26 years. His mother regrets putting him on the drugs when he was 9-years-old for Tourette’s syndrome, obsessive-compulsive disorder (OCD), and generalized anxiety disorder. The man described in the story believes the drugs stifled his full range of emotions and prevented him from living an authentic life.
Cameron describes his experience as emotional numbness, and he always had difficulty forming deep friendships. He attempted to stop taking the antidepressants multiple times, which triggered severe anxiety, panic, mood swings, and withdrawal. Cameron has been slowly tapering off the drugs for the last three years with assistance from his doctor. Dr. Mark Horowitz, a YouTuber who advocates for deprescribing from antidepressants, suggests it takes two months of tapering for every year a person has been on SSRIs.
While the amount of reliance on pain relievers, tranquilizers, stimulants, and sedatives has decreased to about one-third of all American adults and one-sixth of American adolescents, the amount of antidepressant usage has increased slowly during the same time period. The current medical system doesn’t prioritize or understand the best ways of deprescribing antidepressants, and there aren’t enough psychotherapists to handle the demand from people who would like to avoid taking them when treating depression.