Indications for antidepressant drug prescribing in general practice in the Netherlands

Gardarsdóttir, Helga; Heerdink, Eibert R.; Dijk, Liset van; Egberts, Toine C. G.

doi:10.1016/j.jad.2006.07.003

Cited by 144 publications

(131 citation statements)

References 23 publications

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“…SSRIs, on the other hand, were the most common group (125, 32.8%) used for the treatment of depression followed by mirtazapine (113, 29.7%) ( Table 2). This result is compatible with most clinical guidelines for treatment of depression and similar to utilization studies conducted in some developed countries [6,7,[12][13][14]. Furthermore, the use of mirtazapine is increasing due its efficacy and safety over other classes especially in regards to sexual adverse effects [15].…”

Section: Discussionsupporting

confidence: 84%

“…Monotherapy accounted for the majority of prescriptions (89.3%). Venlafaxine and mirtazapine were the most common prescribed combination (16) followed by fluoxetine and mirtazapine (9) and amitriptyline and mirtazapine (6). There were no gender differences in the use of antidepressant drugs (Table 1).…”

Section: Methodsmentioning

confidence: 99%

“…This evolution has also lead to a continues changes in their prescribing patterns where the conventional agents like tricyclic antidepressants (TCA), and monoamine oxidase inhibitors (MAOI), selective serotonin reuptake inhibitors (SSRIs) being replaced by newer antidepressants like serotonin/ norepinephrine reuptake inhibitors (SNRIs), tetracyclic antidepressants and others. The trends in the usage of these agents, influenced by various factors, vary from a country to another [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Utilization Pattern of Anti-Depressants at a Tertiary Hospital in Oman: A Retrospective Analysis

2014

J Psychiatry

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Section: Discussionsupporting

confidence: 84%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Utilization Pattern of Anti-Depressants at a Tertiary Hospital in Oman: A Retrospective Analysis

2014

J Psychiatry

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“…We used antidepressant use as a proxy for depression. A limitation of this approach is that not all depressed patients are treated with antidepressants and that not all antidepressant users have an indication of depression [16]. However, more severe depression is likely to be recognised and treated [17], and therefore antidepressant use may be a valid proxy for more severe and debilitating depression.…”

Section: Discussionmentioning

confidence: 99%

Antidepressant use before and after initiation of diabetes mellitus treatment

et al. 2009

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Aims/hypothesis Although current literature suggests an association between diabetes and depression, the direction of the association is unclear. We examined the temporal association between diabetes and depression by studying antidepressant and benzodiazepine use around the initiation of diabetes treatment. Methods From a pharmacy registry database we selected 49,593 diabetic patients and a random sample of non-diabetic individuals (n=154,441), all >40 years old. Antidepressant and benzodiazepine use was calculated for the 7 years before and 7 years after the index date. The index date in diabetes patients was defined as the date of initiation of diabetes medication. A random index date was assigned to nondiabetic individuals. Time-specific incidence rate ratios of antidepressant and benzodiazepine use were calculated for intervals of 1 year, 3 months and 1 month. Results Antidepressant and benzodiazepine use was increased 2 months before and 3 months after the initiation of diabetes treatment compared with non-diabetic individuals.The strongest increase in incidence of antidepressant and benzodiazepine use was seen in the month after initiation of diabetes treatment with incidence rate ratios of 2.4 (95% CI 2.0-3.0) and 3.4 (95% CI 3.0-3.8) respectively, after adjustment for age, sex and Chronic Disease Score. Conclusions/interpretation The increased incidence of antidepressant and benzodiazepine use may be a consequence of the burden of disease, of starting with diabetes medication or of being diagnosed with diabetes. Our findings could also reflect earlier detection by their physician.

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“…In clinical practice, antidepressants are prescribed for a broad range of indications, including mental and psychological problems other than depression or anxiety. 12,25,26 Antidepressants used for indications other than depression and anxiety have been shown to be correlated with discontinuation of drug taking. 12,26 The present study shows that the indication is an important factor during the initiation phase of treatment as well.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Initiation of antidepressant therapy: do patients follow the GP's prescription?

Geffen¹,

Gardarsdóttir²,

Hulten³

et al. 2009

Br J Gen Pract

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Retrospective study linking a general practice to a pharmacy dispensing database. SettingGeneral practice in the Netherlands. MethodStudy population: patients who received a first-time antidepressant prescription from a GP. Three patient groups were identified: patients who did not fill the prescription (non-fillers); patients who filled only a single prescription (single Rx-fillers); and patients who filled at least two consecutive prescriptions. Non-fillers and single Rx-fillers were combined into a group of decliners. ResultsOf all 965 patients, 41 (4.2%) did not fill the prescription, and 229 (23.7%) filled only a single prescription. Patients who consulted their GP for a non-specific indication, rather than for depression, anxiety, panic, or obsessive-compulsive disorder, were almost three times more likely (odds ratio [OR] = 2.7, 95% confidence interval [CI] = 1.8 to 3.9) to decline treatment. Further, the risk of declining was almost fivefold higher (OR = 4.8, 95% CI = 2.1 to 11.3) in nonWestern immigrants, and almost twofold higher (OR = 1.8, 95% CI = 1.2 to 2.8) in patients >60 years of age. ConclusionOver one in four patients who receive a first-time antidepressant prescription decline treatment; they either do not initiate drug taking or do not persist with antidepressant use for longer than 2 weeks.

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Indications for antidepressant drug prescribing in general practice in the Netherlands

Abstract: GPs prescribe antidepressants predominantly for treating depression. However, using antidepressant drug as a proxy for identifying depressed patients in a prescription database should be done with caution and when possible in combination with clinical data.

Cited by 144 publications

References 23 publications

Utilization Pattern of Anti-Depressants at a Tertiary Hospital in Oman: A Retrospective Analysis

Utilization Pattern of Anti-Depressants at a Tertiary Hospital in Oman: A Retrospective Analysis

Antidepressant use before and after initiation of diabetes mellitus treatment

Initiation of antidepressant therapy: do patients follow the GP's prescription?

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