CHANGES IN THE PATTERN OF ANTIDEPRESSANT USE UPON THE INTRODUCTION OFTHE NEW ANTIDEPRESSANTS - A PRESCRIPTION DATABASE STUDY

Objective: To study whether the newer antidepressants have changed the patterns of antidepressant use, and whether the claimed better advers e effect profile of the newer antidepressants is reflected in their us e as monitored by a prescription database. Method: By means of a presc ription database (OPED), the use of antidepressants from 1991 to 1993 in Odense, Denmark, was analysed. Results: The 1-year prevalence of an tidepressant use increased significantly from 1.60% to 2.00%, which st ill is below the claimed 1-year prevalence of depression of at least 5 %. The increase was mainly due to a rapidly increasing use of the newe r antidepressants, accompa nied by a moderate decline in the use of ol der antidepressants (mainly tricyclic antidepressants). The patterns o f antidepressant use were very polymorphic, with about 5% being on con tinuous use for all 3 years and groups of each 20-30% being treated wi th: (I) several series or (2) one series or (3) only by one prescripti on. The share of patients presenting only one prescription (20%) was t he same for older and newer antidepressants. Likewise, the rate of shi fts from older to newer antidepressants or Vice versa was the same (7% vs 6%). The duration of treatment did not differ much between older a nd newer antidepressants. Relative to the defined daily dose (DDD), th e older antidepressants were given in much lower doses (median 0.63 DD D) than the newer antidepressants (median 1.05 DDD). Conclusion: It is concluded that many depressed patients are still not receiving antide pressant treatment and that the claimed better adverse effect profile of the newer antidepressants was not clearly reflected in their use.