SSRI antidepressant drug use patterns in the naturalistic setting - A multivariate analysis

BACKGROUND. The study of the duration and pattern of antidepressant use in actual clinical practice can provide important insights into how antidepres sant prescribing patterns compare with recommended depression treatment gui delines. OBJECTIVE. The purpose of this study, using data available from depressed o utpatients in the United States, is to assess the effects of initial SSRI a ntidepressant selection on the subsequent pattern and duration of antidepre ssant use, RESEARCH DESIGN. Multiple logistic regression analysis of data from a large prescription and medical claims database (MarketScan(TM)) for the years 19 93 and 1994 were used to estimate the determinants of antidepressant drug u se patterns for 1,034 patients with a "new" episode of antidepressant thera py who were prescribed one of three most often prescribed selective seroton in reuptake inhibitors (SSRIs), paroxetine, sertraline, or fluoxetine. RESULTS. Patients initiating therapy on sertraline or paroxetine were less likely than patients initiating therapy on fluoxetine to have four or more prescriptions of their initial antidepressant within the first 6 months. CONCLUSIONS. The findings suggest that antidepressant selection is an impor tant determinant of the initial duration and pattern of antidepressant use which is consistent with current recommended depression treatment guideline s.