Survey of new antidepressants in secondary care

INTRODUCTION: There ave no conclusive data to support the superior efficacy of any one antidepressant, while costs and side-effects are known to diffe r. The use of venlafaxine has been observed to be increasing within local s ervices and this is associated with significant cost. This survey examined the patterns of use of new antidepressants by psychiatrists in the UK. METHOD: 188 questionnaires were sent to hospital pharmacists. The doses of fluoxetine, paroxetine, sertraline and venlafaxine rued for the treatment o f depression over a 1-week census period were recorded, together with the t otal quantities of each drug supplied by hospital pharmacies in the financi al rear 1997/1998. RESULTS: 84 completed replies were received (45%), with a total number of 2 060 prescriptions for depression, making this the largest survey to date of antidepressant prescribing by psychiatrists. Fluoxetine and paroxetine wev e associated with less dosage titration and cost less per treatment month t han sertraline and venlafaxine. CONCLUSION: Venlafaxine has not been consistently proven to be move effecti ve than other antidepressants and is move costly, yet its use by psychiatri sts is increasing nationally. Comparative data such as these are not routin ely available for hospital cave in the UK. The new NHS will bring more dema nd for such data and move accountability for its content.