The epidemiology of antidepressant use in South Korea: Does short-term antidepressant use affect the relapse and recurrence of depressive episodes?

Abstract

BackgroundThe duration of antidepressant use affects the treatment of depression. Using the National Health Insurance database, which covers almost the entire national population, we verified the factors associated with the inadequate short-term use of initially prescribed antidepressants and their effects on the relapse and recurrence of depressive episodes.MethodsThere were 752,190 patients included who had been newly prescribed antidepressants in 2012 with the diagnosis of depressive disorder. They were followed-up until December 31, 2015. They were classified as short-term and long-term antidepressant users depending on whether they used a specific initial antidepressant for at least four weeks. Sociodemographic, clinical, and medical utilization factors affecting the duration of antidepressant use were investigated. We also identified whether the duration of antidepressant use affected the risk of relapse and recurrence, which was defined by the restarting of antidepressants.ResultsInitial antidepressants were taken for less than 28 days by 458,057 (60.84%) patients. Tricyclic antidepressants were used as the initial antidepressant more frequently than selective serotonin reuptake inhibitors (64.5% versus 19.3%). The type of initial antidepressant, polypharmacy, psychiatric and medical comorbidities, type of insurance coverage, and type of medical institution visited were associated with short-term use. Short-term use marginally increased the risk of relapse and recurrence of depressive episodes (Hazard ratio: 1.06, 95% confidence intervals 1.048–1.075).ConclusionsShort-term antidepressant use is widespread in Korea, and assessment in various aspects are necessary to set proper treatment plans.

Treatment patterns and sequences of pharmacotherapy for patients diagnosed with depression in the United States: 2014 through 2019

“…This study did not examine the average time patients were actively receiving each treatment, or how long patients may have been with no treatment between switching from one class to the next, as it was outside of the scope of this research. Discontinuation of antidepressant treatment is common and has been identified as a risk factor for relapses [29][30][31][32][33].…”

Identifying High-Risk Factors of Depression in Middle-Aged Persons with a Novel Sons and Spouses Bayesian Network Model

“…Until now, research into middle-age depression has been limited to trend analysis [ 3 ]. Although the maturity hypothesis has been put forward to explain why this age group is at low risk, numbers indicating the use of depressive drugs within this age group suggest a different reality [ 9 , 10 ]. If we consider the pace of the modern economy and how quickly one’s life can change, for good and bad, analysis of the risk factors for depression in this age group has valid grounds for further research.…”

“…Based on numbers provided by the American Psychological Association (APA) in 2017, 12.7% of the American population were actively taking antidepressants, with 16.6% of the population falling between the ages of 40 and 59 [ 9 ]. In South Korea, for example, short-/long-term use of antidepressants for the same age group was shown to be 21.25% [ 10 ]. Based on these figures, it could be suggested that depression is potentially more prevalent in middle ages compared to what was previously found [ 3 ].…”

Trends in Antidepressants Use in Spain between 2015 and 2018: Analyses from a Population-Based Registry Study with Reference to Driving

“…Depression causes severe disabilities in the occupational and social life of patients [1] and it is currently recognized as a global public health concern [2]. According to the World Health Organization (WHO), major depressive disorder will become the second leading cause of disability around the world in 2030 [2].…”

“…Antidepressants that hold the Anatomical Therapeutic Chemical (ATC) code N06 are classified in four subgroups [11]: (1) non-selective monoamine reuptake inhibitors (or tricyclic antidepressants, TCAs) (N06A), (2) selective serotonin reuptake inhibitors (SSRIs) (N06B), (3) non-selective monoamine oxidase A inhibitors (N06AF), (4) monoamine oxidase A inhibitors (N06AG), and (5) "other antidepressants" (N06AX). Each of these antidepressant types has a particular side-effects profile.…”