Selective serotonin reuptake inhibitors have broadened the utilisation of antidepressant treatment in accordance with recommendations: Findings from a Swedish prescription database

• Published in: Journal of affective disorders Vol. 53; no. 1; pp. 15 - 22
• Main Authors: Isacsson, Göran, Boëthius, Göran, Henriksson, Svante, Jones, Judith K, Bergman, Ulf
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.04.1999; Elsevier
• Subjects: Adult; Antidepressants; Antidepressive Agents, Tricyclic - economics; Antidepressive Agents, Tricyclic - therapeutic use; Biological and medical sciences; Databases as Topic; Depressive Disorder - drug therapy; Depressive Disorder - epidemiology; Drug Monitoring; Drug Prescriptions - statistics & numerical data; Female; Humans; Incidence; Male; Medical sciences; Medicin och hälsovetenskap; Mental health; Neuropharmacology; Organization of mental health. Health systems; Pharmacoepidemiology; Pharmacology. Drug treatments; Prevalence; Prospective Studies; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Serotonin Uptake Inhibitors - economics; Serotonin Uptake Inhibitors - therapeutic use; Sex Distribution; Social psychiatry. Ethnopsychiatry; SSRIs; Sweden - epidemiology; TCAs; Time Factors; Treatment of depression; Sweden; Europe; Pharmacoepidemiology; Treatment of depression; SSRIs; Antidepressants; TCAs; Mood disorder; Human; Chemotherapy; Treatment; Serotonin; Medical prescription; Psychotropic; Mental health; Antidepressant agent; Depression; Reuptake inhibitor; Public health
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/S0165-0327(98)00083-4

Background: With the advent of the selective serotonin reuptake inhibitors (SSRIs), the use of antidepressants has increased drastically in Sweden. The use of tricyclic antidepressants (TCAs) has, however, decreased. Methods: We surveyed a prescription database in the Swedish county of Jämtland and compared prescription patterns for patients prescribed SSRIs with those prescribed TCAs. Results: The incidence of treatments of antidepressants increased from 0.76% to 1.33% during the period 1991–1996. There were no significant differences between SSRIs and TCAs with regard to patients having only one prescription dispensed within three months from the index prescription, or patients who switched class of antidepressant. Only a minority of the treatments were continued for at least six months, but significantly more SSRI than TCA treatments (42% and 27%). A second treatment period suggesting recurrence was three-times more common in the TCA group than in the SSRI group. Conclusion: Provided that the increased use of SSRIs is mainly for depression, these drugs appear, despite a lower efficacy in severe depression, to have enabled a broader utilisation of antidepressants with regard to incidence, dosage and duration, in accordance with recommendations. Further analyses of this phenomenon relative to diagnostic criteria and outcome measures are required.