Affiliation:
1. Faculty of Medicine, Belgrade + Clinic for Psychiatry, Clinical Centre of Serbia, Belgrade
2. Clinic for Psychiatry, Clinical Centre of Serbia, Belgrade
Abstract
Background/Aim. Antidepressants are a widely used class of drugs. The aim of
this study was to investigate different aspects of antidepressant prescribing
practice at University Psychiatric Clinic in Belgrade. Methods. This
cross-sectional study was carried out by retrospective analysis of the
patient's medical charts. The study included all patients with antidepressant
prescribed at discharge during 2009 (n = 296). The evaluation was focused on
patient- related factors (socio-demographic and illness related),
psychiatrist-related factors (sex and duration of working experience) and
drug related factors (type of antidepressant, dose, polypharmacy and
reimbursement by national health insurance). Results. Antidepressants were
prescribed for unipolar depression (F32-34, ICD X) either without comorbidity
(46.2%) or with comorbidity (24.7%), mostly as a monotherapy (91% had one
antidepressant), to the patients who were 65% female, aged 50.1 ? 8.9, most
of them with 12 years of education (52.6%), married (69.3%) and employed
(55.9%). The majority of patients had a history of two hospitalizations (Med
2; 25th-75th perc. 1-4) during nine years (Med 9; 25th-75th perc. 2-15) after
the first episode of depression. Among them, 19% were found to be suicidal in
a lifetime. The single most prescribed antidepressant was sertraline (20.4%),
followed by fluoxetine (13.3%) and maprotiline (11.7%). Utilization of
antidepressants was positively correlated with the rate of reimbursement (p <
0.01). The most prescribed antidepressant group was selective serotonin
reuptake inhibitors (SSRI) (47.8%), followed by tricyclic antidepresants
(TCA) (25.3%) and new antidepressants - venlafaxine, tianeptine, mirtazapine,
bupropion, trazodone (15.1%). Most of the drugs were prescribed in doses
which are at the lower end of the recommended dose-range. Regarding severity
of the actual depressive episode, TCA were prescribed for severe depression
with psychotic features, while SSRI were choice for episodes with moderate
symptom severity (p = 0.01). Psychiatrists with longer working age (20-30
years) hesitated to prescribe new antidepressants in comparison to younger
colleagues (p = 0.01). Conclusion. Economic issues in Serbia as developing
country influence the choice of antidepressants, as well as a psychiatrist?s
working age and severity of depression. However, SSRI are the drugs of the
first choice, as it was shown in most of the developed countries nowadays.
Publisher
National Library of Serbia
Subject
Pharmacology (medical),General Medicine
Cited by
7 articles.
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