In the past 15 years, the amount of anti-depressant drugs prescribed in Scotland has quadrupled. It is a startling statistic, which many will see as a thoroughly depressing indicator of the health and wellbeing of the nation. In human terms, around 65 women and 30 men in every 1000 consult their GP with depression. They are most likely to do so if aged between 25 and 44 and, particularly, have a high level of social deprivation. However, the statistics bear closer scrutiny: although the number of anti-depressant drugs being taken has increased, it does not mean more people are depressed. Since the steep increase in prescriptions is not matched by an increase in consultations, the current high level of 85 daily doses of anti-depressants prescribed for every 1000 people will be due to a number of other factors.

The level of prescriptions for anti-depressant drugs is alarming and, as a number of mental-health charities suggest, point to a lack of alternative treatments such as cognitive behavioural therapy. That is likely to result in overdependence on medication.

Guidelines are clear: anti-depressants should not be prescribed for the initial treatment of mild depression, but they can be very effective in treating the symptoms of moderate to severe depression. What is mild, moderate or severe is, of course, a matter of clinical judgment, but there are recognised assessment scales for determining the degree of illness. It is a common belief that GPs prescribe anti-depressants, particularly the newer selective serotonin reuptake inhibitors (SSRIs), which include Prozac and Seroxat, as a "quick fix" for patients whose problems are partly medical and partly the result of factors such as unemployment, poor housing and bad diet.

Inevitably, the highest rate of prescriptions is in Greater Glasgow, but before condemning doctors for subscribing to a culture of "a pill for every ill", it is worth bearing in mind the clinical guidelines for SSRIs: that the treatment of depression with anti-depressants should continue for six months after recovery to avoid relapses. In the case of a second or subsequent episode of depression, the guidelines now suggest prescribing for two years. This almost certainly means that a large part of the increase in prescriptions is due to people taking the drugs for longer rather than many more people being prescribed them.

The previous Scottish Executive imposed a target of reducing the annual increase in anti-depressants to zero by 2009. The SNP made a commitment in its manifesto to cut the number by 10% over the same period. It is unlikely this will be achieved, but there is too little information on alternative treatments. There are no national statistics on waiting times, delivery and outcomes for psychological therapies in Scotland. That should be remedied as a first step towards improving provision of such services. The best outcome for patients is likely when they are available in conjunction with drug therapy. Rather than an arbitrary target for reducing anti-depressants, we need a wider examination of our approach to and treatment for depression.