Consumption of Antidepressants in Italy: Recent Trends and Their Significance for Public Health

Gualano, Maria Rosaria; Bert, Fabrizio; Mannocci, Alice; Torre, Giuseppe La; Zeppegno, Patrizia; Siliquini, Roberta

doi:10.1176/appi.ps.201300510

Cited by 38 publications

(21 citation statements)

References 30 publications

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“…The prevalence of use was higher in patients than in the population, with a difference of about 30%. Among the population the use increased over time, consistently with recent data on ATDs consumption in Italy [30]. …”

Section: Discussionsupporting

confidence: 77%

The Use of Antidepressant Medication before and after the Diagnosis of Amyotrophic Lateral Sclerosis: A Population-Based Cohort Study

et al. 2015

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Background: The prevalent use of antidepressants (ATDs) in patients with Amyotrophic Lateral Sclerosis (ALS) varies across cross-sectional and clinic-based published studies. This population-based cohort study assesses the real-world prevalence of the use of ATDs, its trajectory and the association of incident use with clinical characteristics. Methods: All patients with incident ALS in the Friuli Venezia Giulia region, Italy, from 2002 to 2009, were identified through multiple sources including health databases. Diagnosis was validated through clinical documentation review. ATDs prescriptions from 2000 to 2011 were obtained from regional database. The trajectory was estimated through generalized estimating equations for repeated measures logistic regression and the Hazard ratio (HR) of initiating ATDs through multivariate proportional hazard Cox regression. Results: In this cohort of 261 ALS cases, age-, sex-adjusted prevalence of the use of ATDs was 37.3%, higher than in general population. The trajectory increased by 16% in 1-year period across diagnosis. Age ≤67 years at diagnosis (HR 1.28, 95% CI 0.84-1.95) and bulbar onset (1.43, 95% CI 0.90-2.26) were positively associated with initiating ATDs after diagnosis. Conclusions: More than one-third of patients used ATDs. Depression may occur more frequently than previously reported. Depression may precede motor alterations and be related to both ALS diagnosis and progression.

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Section: Discussionsupporting

confidence: 77%

The Use of Antidepressant Medication before and after the Diagnosis of Amyotrophic Lateral Sclerosis: A Population-Based Cohort Study

et al. 2015

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“…Z drugs (zopiclone) appear to have replaced in part benzodiazepines in Scandinavian countries [38] , hydroxyzine in France [33] and SSRI/SNRI in Italy [39] .…”

Section: Discussionmentioning

confidence: 99%

Hypnotics and Triazolobenzodiazepines - Best Predictors of High-Dose Benzodiazepine Use: Results from the Luxembourg National Health Insurance Registry

Cloos¹,

Bocquet

Rolland-Portal³

et al. 2015

Psychother Psychosom

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Background: Benzodiazepines are not all the same concerning their risk of high-dose use. Methods: We studied benzodiazepine use from the Luxembourg national records of all insured. We calculated the 12-year prevalence from 1995 to 2007. Benzodiazepine users were divided into 3 groups, short-term with no longer than 3-month intake, intermediate with multiple administration with at least a 1-year interruption, and continuous who never stopped. A high-dose user (HDU) was defined as a patient who received a higher dose than the yearly maximum usual therapeutic dose. Results: An average of 16.0% of the adult insured population received at least 1 benzodiazepine annually, 42.9% were older than 50, 55.9% were women, and 5.4% were HDUs. We found that 32.6% were short-term users, 49.0% intermediate and 18.4% continuous. Compared to diazepam, hypnotics had higher risks for high-dose use in at least 1 age group at first-benzodiazepine intake, the risks being greater in elderly subjects and women, the highest risks being with triazolam (adjusted odds ratio = 215.85; 95% confidence interval = 133.75-348.35) in the 69- to 105-year-old group at first-benzodiazepine intake. Anxiolytics had a low risk except for alprazolam and prazepam in the 69- to 105-year-old group at first-benzodiazepine intake, clonazepam and clobazam had the lowest risk in 18- to 43-year-olds at first-benzodiazepine intake. Alprazolam had dispensed volumes increased by threefold over the 12-year period. Conclusion: All hypnotics had higher risks for high-dose use compared to diazepam in continuous users. Two anxiolytics, clonazepam and clobazam, had the lowest risks. Hypnotics and the triazolobenzodiazepines alprazolam and triazolam were most problematic. Elderly subjects and women are at greater risks.

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“…The most common prescription in the second period (2008–2011) was paroxetine, followed by escitalopram and then venlafaxine. A study conducted in Italy between 2000 and 2011 recorded an increase in the consumption of antidepressants and especially the group of selective serotonin reuptake inhibitors (SSRIs) [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Monitoring patients on chronic treatment with antidepressants between 2003 and 2011: analysis of factors associated with compliance

et al. 2015

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BackgroundClinical practice guidelines consider the use of antidepressants as one of the standard treatments for anxiety disorders, due to the significant improvements obtained in quality of life and functional disability. In addition, in patients who have not achieved a favorable response after 3 months of psychotherapy, antidepressants are recommended as part of a combined treatment approach. This combination with psychotropic drugs and psychotherapy appears to be indicated from baseline in patients with moderate, severe or recurrent depression. In the last decade, antidepressant prescription rates in general practice have increased between 4 and 10 times. Depression presents high rates of relapse and recurrence. Treatment is often interrupted prematurely, leading to increases in both relapse rates and health care costs. Few studies have analysed the chronic use of antidepressant drugs and long-term adherence. Objective: To evaluate compliance with antidepressant treatment between 2003 and 2011 and to explore the associated factors.MethodsRetrospective cohort study of antidepressant dispensing. Setting: Health Region of Lleida between 2003 and 2011. Participants: Patients with chronic prescription of antidepressants (ATC code NO6A) during 2003 were followed up until December 2011. The sample comprised 3684 subjects. Main measures: The compliance rate was calculated on the basis of the number of units withdrawn from the pharmacy and the theoretical number of units required according to the scheduled duration of treatment: compliance was defined in cases with scores greater than or equal to 80 %.Results12.5 % of patients received chronic antidepressant treatment for at least 4 years. Mean age was 54 years, and 73.2 % of patients were female. Almost a third (32.4 %) presented anxiety disorders and 26.5 % mood disorders. The overall compliance rate was 22 % (28 % in patients with depression, and 21 % in patients with anxiety). According to gender, compliance rates were 21.4 % for males and 22.4 % for females. Compliance was more likely in patients with polypharmacy.ConclusionsOne in 4 patients complied with treatment. Factors associated with better compliance were polypharmacy and diagnosis of depressive or mixed anxiety-depressive disorder.

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Consumption of Antidepressants in Italy: Recent Trends and Their Significance for Public Health

Cited by 38 publications

References 30 publications

The Use of Antidepressant Medication before and after the Diagnosis of Amyotrophic Lateral Sclerosis: A Population-Based Cohort Study

The Use of Antidepressant Medication before and after the Diagnosis of Amyotrophic Lateral Sclerosis: A Population-Based Cohort Study

Hypnotics and Triazolobenzodiazepines - Best Predictors of High-Dose Benzodiazepine Use: Results from the Luxembourg National Health Insurance Registry

Monitoring patients on chronic treatment with antidepressants between 2003 and 2011: analysis of factors associated with compliance

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