Our study documents that 1.8% (1,319,763/73,860,558) of patients in 2007-2008 were prescribed triptan, and SSRI or SNRI (vs 1.3% in 2003-04, an increase of 38.5%). While this is a small fraction overall, the actual number of patients on a nationwide basis is substantial. What remains missing from the literature is documentation as to the number of cases of serotonin syndrome and resulting consequences (clinical and economic) because of the concomitant use of triptan, and SSRI or SNRI in the time-frame 2007-2008. Absent in these data, it remains difficult to assess the risk benefit associated with the use of triptan, and SSRI or SNRI.
By 2003-2004, the population-adjusted rates for non-Hispanic Blacks and Hispanics were similar, and remained so through 2007-2008. However, over the 12-year time-frame examined, the rates for both minority groups were, in each 2-year interval, far less than that observed in non-Hispanic Whites. Disparities remain by ethnicity/race in the diagnosis and treatment of depression in the US.
Data from the US National Ambulatory Medical Care Survey (NAMCS) for the years 1991 through 2008 were used for this analysis. 23 The US NAMCS is a national probability sample designed and conducted by the US National Center for Health Statistics (NCHS) of the US Centers for Disease Control and Prevention. Data are collected by the US Bureau of the Census. The study is cross-sectional in design. The 3-stage probability sampling procedure, sampling variation, and estimation procedures for the US NAMCS have been described in detail elsewhere. 24 The basic sampling unit is the OBV.
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