We investigated job burnout and job characteristics, including decision authority, skill discretion, predictability, and information flow, among Finnish forestry workers (N = 4356) in a longitudinal study. We linked these responses individually with data on the participants' subsequent prescriptions for psychotropic drugs including antidepressants. We aim to study the antecedents of changes in burnout levels over four years time and their health-related consequences in an eight-year follow-up. The results showed that inconsistency among the levels of the Maslach Burnout Inventory subscales (e. g., high scores in exhaustion and low cynicism or vice versa) at baseline identified patterns that were prone to change in burnout four years later. Information flow predicted the direction of this change for the exhaustion and cynicism aspects of burnout, whereas skill discretion and predictability did so for reduced professional efficacy. Change toward burnout predicted future risk of psychotropic drug use. It seems that adverse changes in burnout are influenced by poor organizational resources, and change toward burnout is likely to elevate the risk of poor mental health. Copyright © 2012 John Wiley & Sons, Ltd.