Selective serotonin reuptake inhibitors have broadened the utilisation of antidepressant treatment in accordance with recommendations - Findings fromSwedish prescription database

Background: With the advent of the selective serotonin reuptake inhibitors (SSRIs), the use of antidepressants has increased drastically in Sweden. Th e use of tricyclic antidepressants (TCAs) has, however, decreased. Methods: We surveyed a prescription database in the Swedish county of Jamtland and compared prescription patterns for patients prescribed SSRIs with those pre scribed TCAs, Results: The incidence of treatments of antidepressants incre ased from 0.76% to 1.33% during the period 1991-1996. There were no signifi cant 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 S SRI 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 g roup. Conclusion: Provided that the increased use of SSRIs is mainly for de pression, these drugs appear, despite a lower efficacy in severe depression , to have enabled a broader utilisation of antidepressants with regard to i ncidence, dosage and duration, in accordance with recommendations. Further analyses of this phenomenon relative to diagnostic criteria and outcome mea sures are required. (C) 1999 Elsevier Science BSI. All rights reserved.