Treatment of depression: Prescription for success?

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Abstract

A prospective, population-based study which aimed to examine prescribing patterns of antidepressant drugs was performed in Tayside. All dispensed prescriptions for antidepressants in this area of Scotland were recorded on a computerized database, and linked with hospitalization data. Over the 14-month study period, 14 988 (74%) patients were given only tricyclic antidepressants (TCAs), 3571 (18%) were given only selective serotonin reuptake inhibitors (SSRIs) and 1636 (8%) were given both. Seventy-two per cent of patients were given TCAs at a subtherapeutic dose (as defined by a consensus statement on the use of antidepressants) compared with only 8% of patients given SSRIs at a subtherapeutic dose. However, both classes of drugs were given for inadequate durations. No differences were found in the rate of hospitalization for cardiovascular events or convulsions between patients taking TCAs and those taking SSRIs, although there is the possibility that these data may be confounded as a result of SSRls being prescribed in preference to TCAs in at-risk patients. There was an increased risk of hospital admission for acute retention of urine while taking a TCA. Evidence of the ineffective use of antidepressant therapy from this study provides cause for concern. Further research should address the reasons for this prescribing behaviour and seek to determine how the treatment of depression can be made more rational.

Original languageEnglish
Pages (from-to)S7-S10
Number of pages4
JournalPrimary Care Psychiatry
Volume3
Issue numberSuppl. 1
Publication statusPublished - 1997

Keywords

  • Dosage
  • Hospitalization
  • Inhibitors
  • Population study
  • Selective serotonin reuptake
  • Tricyclic antidepressants

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