ANTIDEPRESSANTS IN GENERAL-PRACTICE - TOO MUCH OR TOO LITTLE

With a source in a prescription database study and the literature, the following points concerning the use of antidepressants (ADs) in gener al practice are discussed: More than half of patients are given ADs fo r indications other than depression. The 12-month prevalence of AD tre atment is 1.6%. Compared with a prevalence of depression estimated at between 2 and 10%, this suggests undertreatment of depression and many depressed patients not diagnosed in general practice. Substantially l ower doses of ADs are used in general practice than in hospitalized pa tients, whose treatment is adjusted by therapeutic drug monitoring. So me patients are treated for very short periods, whereas others are tre ated for years without reconsideration of the indication. Use of the n ew ADs (SSRI and moclobemide) has increased considerably since their i ntroduction in the late 1980s. The indications for AD treatment in gen eral practice may have increased, as has been seen in the United State s. In conclusion, ADs are on the one hand over-used in general practic e, since they are used for indications other than depression and for l ong periods. On the other hand, ADs are underused, since many depresse d patients are not treated at all, some are treated for very short per iods and very low doses are employed.