ANTIDEPRESSANT TREATMENT IN GENERAL-PRACTICE - AN INTERVIEW STUDY

Objective - To elucidate potential problems concerning the use of anti depressants (AD) in general practice. Design - Cross-sectional, descri ptive interview study. Setting - General practices, Odense, Denmark. S ubjects - Random sample consisting of 98 AD users from 12 general prac tices. Main outcome measures - Indication for AD treatment, justificat ion of the treatment, duration of AD treatment, daily dose of AD, side effects, Hamilton depression rating, WONCA score. Results - The prima ry indication for AD treatment was depression (72 patients), partly re gular depression (therapeutic/prophylactic treatment) (n=39), partly d epressive tendencies (n=32) (1 unknown). Median treatment duration was 3 years; 25% had been in treatment for more than 10 years. The genera l practitioners judged the treatment problematic/unacceptable in 23 ca ses, largely because of uncertain indication or because other or no tr eatment was considered better for the patient. The daily doses of AD m ere generally low. Side effects were modest. The patients often had a relatively high depression score and poor status according to the WONC A-scale. Conclusions - The use of low doses, long duration of treatmen t, and uncertainty about the relevance of the treatment are important features of the use of AD by general practitioners. There seems to be a discrepancy between the use of AD in general practice and the scient ifically-based recommendations.