EFFECTIVENESS AND ECONOMIC-IMPACT OF ANTIDEPRESSANT MEDICATIONS - A REVIEW

This article reviews the existing literature on the pharmacoeconomics and effectiveness of antidepressant medications. Although selective se rotonin reuptake inhibitors (SSRIs) have not proved to be more efficac ious than the older tricyclics, and their prescription costs are signi ficantly higher, they provide superior effectiveness; ie, patients are less likely to discontinue taking them or switch antidepressants. Pha rmacoeconomic studies consistently demonstrate a relationship between this superior effectiveness and reductions in overall treatment-costs, often through decreased utilization of medical and hospital services; The most conservative study found a cost offset that more than negate d the extra cost of drugs, although the cost savings were not statisti cally significant. Other studies found statistically significant lower ing of utilization costs by using SSRIs rather than tricyclics. Studie s comparing SSRIs with each other present conflicting findings, althou gh fluoxetine appears to have an edge over sertraline and paroxetine w ith regards to effectiveness and pharmacoeconomics. More studies emplo ying a prospective outcome design and naturalistic study setting need to be conducted with SSRIs and other new antidepressants.