scholarly journals Effect of increased antidepressant prescribing on suicide rate in Northern Ireland

1999 ◽  
Vol 23 (8) ◽  
pp. 484-486 ◽  
Author(s):  
Christopher B. Kelly ◽  
Thérèse Rafferty
Keyword(s):  
Northern Ireland ◽  
Suicide Rate ◽  
Antidepressant Treatment ◽  
Depressive Illness ◽  
Clinical Implications ◽  
Defined Daily Dose ◽  
Central Unit ◽  
Antidepressant Prescription ◽  
Daily Dose ◽  
Antidepressant Use

Aims and methodTo investigate whether changes in antidepressant prescribing have been associated with alteration in suicide rate for the period 1989–1996 in Northern Ireland. Data for antidepressant prescribing were obtained from a central unit, for Northern Ireland, using the defined daily dose system for each of the above years. The number of recorded cases of suicide and undetermined death were also obtained for this period, from Northern Ireland coroners.ResultsThere was no evidence of an association between suicide rate and antidepressant prescription (r2=0.019, F test=0.115, P=0.74), despite antidepressant use more than tripling over the study period.Clinical implicationsEven substantial increases in detection and treatment of depressive Illness may not impinge on suicide rate. It Is also possible that suicide rate may be a very poor marker of the benefits of antidepressant treatment.

Antidepressant prescribing and suicide rate in Northern Ireland

2003 ◽  
Vol 18 (7) ◽  
pp. 325-328 ◽  
Author(s):  
Christopher B Kelly ◽  
Tanzeel Ansari ◽  
Thérèse Rafferty ◽  
Mike Stevenson
Keyword(s):  
Northern Ireland ◽  
Linear Regression ◽  
Unemployment Rate ◽  
Suicide Rate ◽  
Depressive Illness ◽  
Aggregate Data ◽  
Effective Strategy ◽  
Older Individuals ◽  
Political Factors ◽  
Total Group

AbstractPurposeAlthough antidepressants are the most commonly used treatment for depressive illness, there is uncertainty if their use is associated with a reduction in suicide rate. Antidepressant prescribing in Northern Ireland has increased over fivefold in the decade 1989–1999. The authors sought to explore whether this increase was associated with a reduction in suicide rate taking into account social and political factors thought also to have an influence on suicide.Materials and methodsFactors that have been suggested to influence suicide were entered into a linear regression with frequency of suicide and undetermined deaths (referred to as suicide rate) as the dependent variable. The above factors were antidepressant prescribing, unemployment rate, household alcohol expenditure and persons charged with terrorist offences. The rise in younger suicides, in recent decades, suggests this analysis should be carried out separately for younger (less than 30 years) and older (30 years and above) suicides separately. The predictors in the two models are based on aggregate data for the total group.ResultIn the younger group there was no association between antidepressant prescribing and suicide. For the older group increased antidepressant prescribing was associated with a reduction in suicide rate over the 10 years of the study.ConclusionIncreasing antidepressant prescribing appears to be an effective strategy for reducing suicide. This has been demonstrated in older individuals.

scholarly journals Antidepressant Use and Suicide Rates in Adults Aged 75 and Above: A Swedish Nationwide Cohort Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Khedidja Hedna ◽  
Johan Fastbom ◽  
Annette Erlangsen ◽  
Margda Waern
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Suicide Rate ◽  
Decomposition Analysis ◽  
Swedish Population ◽  
Suicide Rates ◽  
Total Cohort ◽  
Antidepressant Prescription ◽  
Single Use ◽  
Antidepressant Use

Background: The treatment of depression is a main strategy for suicide prevention in older adults. We aimed to calculate suicide rates by antidepressant prescription patterns in persons aged ≥ 75 years. A further aim was to estimate the contribution of antidepressants to the change in suicide rates over time.Methods: Swedish residents aged ≥ 75 years (N = 1,401,349) were followed between 2007 and 2014 in a national register-based retrospective cohort study. Biannual suicide rates were calculated for those with selective serotonin reuptake inhibitor (SSRI) single use, mirtazapine single use, single use of other antidepressants and use of ≥ 2 antidepressants. The contribution of antidepressants to the change in biannual suicide rates was analyzed by decomposition analysis.Results: There were 1,277 suicides. About one third of these were on an antidepressant during their last 3 months of life. In the total cohort, the average biannual suicide rate in non-users of antidepressants was 13 per 100,000 person-years. The corresponding figure in users of antidepressants was 34 per 100,000 person-years. These rates were 25, 42 and 65 per 100,000 person-years in users of SSRI, mirtazapine and ≥ 2 antidepressants, respectively. In the total cohort, antidepressant users contributed by 26% to the estimated increase of 7 per 100,000 in biannual suicide rates. In men, biannual suicide rates increased by 11 suicides per 100,000 over the study period; antidepressant users contributed by 25% of the change. In women, those on antidepressant therapy accounted for 29% of the estimated increase of 4.4 per 100,000.Conclusion: Only one third of the oldest Swedish population who died by suicide filled an antidepressant prescription in their last 3 months of life. Higher suicide rates were observed in mirtazapine users compared to those on SSRIs. Users of antidepressants accounted for only one quarter of the increase in the suicide rate. The identification and treatment of suicidal older adults remains an area for prevention efforts.

Tardive dysphoria: antidepressant-induced chronic depression

2011 ◽  
Vol 28 (1) ◽  
pp. 38-41 ◽  
Author(s):  
Rif S El-Mallakh ◽  
R Jeannie Roberts ◽  
Alan Swann ◽  
Pat R. Rutherford ◽  
Anton Surja
Keyword(s):  
Antidepressant Treatment ◽  
Initial Response ◽  
Depressive Illness ◽  
Chronic Depression ◽  
Treatment Resistant ◽  
Transient Improvement ◽  
Episodic Course ◽  
Antidepressant Use ◽  
Resistant Depression

AbstractObjectives: A significant number of depressed individuals experience inadequate benefit from long-term antidepressant use. This paper investigates the hypothesis that in some individuals persistent use of antidepressants may be prodepressant.Methods: Literature regarding the effect of long-term use of antidepressants was reviewed by searching PubMed and Ovid data bases with terms: antidepressant tachyphylaxis, treatment-resistant depression, chronic depression and antidepressant tolerance.Results: Antidepressant treatment-resistant patients frequently had a positive initial response to antidepressants. When resistance appeared, initial increases in dose or medication changes usually resulted in transient improvement. Eventually, the episodic course of the original depressive illness was replaced with a continuous, unresponsive depressive syndrome. We propose the term tardive dysphoria to describe this phenomenon.Conclusions: The phenomenon of antidepressantinduced depression, or tardive dysphoria, needs to be experimentally examined in blinded, randomised antidepressant discontinuation studies.

Comparison of the defined daily dose and days of treatment methods for evaluating the consumption of antibiotics and antifungals in the intensive care unit

2020 ◽  
Vol 44 (5) ◽  
pp. 294-300 ◽  
Author(s):  
J. Vallès ◽  
S. Fernández ◽  
E. Cortés ◽  
A. Morón ◽  
E. Fondevilla ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Defined Daily Dose ◽  
Treatment Methods ◽  
Daily Dose

scholarly journals Broad-Spectrum Antibiotic Regimen Affects Survival in Patients Receiving Nivolumab for Non-Small Cell Lung Cancer

2021 ◽  
Vol 14 (5) ◽  
pp. 445
Author(s):  
Min Jung Geum ◽  
Chungsoo Kim ◽  
Ji Eun Kang ◽  
Jae Hee Choi ◽  
Jae Song Kim ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Broad Spectrum ◽  
Small Cell ◽  
Defined Daily Dose ◽  
Small Cell Lung ◽  
Broad Spectrum Antibiotic ◽  
Negatively Associated ◽  
Daily Dose

Antibiotic-induced dysbiosis may affect the efficacy of immune checkpoint inhibitors. We investigated the impact of antibiotics on the clinical outcomes of nivolumab in patients with non-small cell lung cancer (NSCLC). Patients who received nivolumab for NSCLC between July 2015 and June 2018 and who were followed up until June 2020 were included in a retrospective cohort analysis. Of 140 eligible patients, 70 were on antibiotics. Overall survival (OS) was shorter in patients on antibiotics (ABX) compared to those not on antibiotics (NoABX) (p = 0.014). OS was negatively associated with piperacillin/tazobactam (PTZ) (HR = 3.31, 95% CI: 1.77–6.18), days of therapy (DOT) ≥ 2 weeks (HR = 2.56, 95% CI: 1.30–5.22) and DOT of PTZ. The defined daily dose (DDD) in PTZ (r = 0.27) and glycopeptides (r = 0.21) showed weak correlations with mortality. There was no difference in progression-free survival (PFS) between ABX and NoABX; however, PFS was negatively associated with the antibiotic class PTZ and DOT of PTZ. Therefore, the use of a broad-spectrum antibiotic, such as PTZ, the long-term use of antibiotics more than 2 weeks in total and the large amount of defined daily dose of specific antibiotics were associated with decreased survival in patients receiving nivolumab for NSCLC.

scholarly journals Implications of a defined daily dose fixed database for drug utilization research studies: The case of statins in Portugal

2021 ◽  
Author(s):  
Catarina Abrantes ◽  
Fernanda S. Tonin ◽  
Joana Reis‐Pardal ◽  
Margarida Castel‐Branco ◽  
Claudia Furtado ◽  
...  
Keyword(s):  
Drug Utilization ◽  
Defined Daily Dose ◽  
Utilization Research ◽  
Daily Dose ◽  
Drug Utilization Research ◽  
Research Studies

scholarly journals National Antimicrobial Consumption: Analysis of Central Warehouses Supplies to In-Patient Care Health Facilities from 2017 to 2019 in Uganda

2021 ◽  
Vol 6 (2) ◽  
pp. 83
Author(s):  
Juliet Sanyu Namugambe ◽  
Alexandre Delamou ◽  
Francis Moses ◽  
Engy Ali ◽  
Veerle Hermans ◽  
...  
Keyword(s):  
Inpatient Care ◽  
Health Facilities ◽  
World Health ◽  
Defined Daily Dose ◽  
Antimicrobial Consumption ◽  
National Medical ◽  
The World ◽  
Daily Dose ◽  
Care Health ◽  
Health Organization

Antimicrobial consumption (AMC) surveillance at global and national levels is necessary to inform relevant interventions and policies. This study analyzed central warehouse antimicrobial supplies to health facilities providing inpatient care in Uganda. We collected data on antimicrobials supplied by National Medical Stores (NMS) and Joint Medical Stores (JMS) to 442 health facilities from 2017 to 2019. Data were analyzed using the World Health Organization methodology for AMC surveillance. Total quantity of antimicrobials in defined daily dose (DDD) were determined, classified into Access, Watch, Reserve (AWaRe) and AMC density was calculated. There was an increase in total DDDs distributed by NMS in 2019 by 4,166,572 DDD. In 2019, Amoxicillin (27%), Cotrimoxazole (20%), and Metronidazole (12%) were the most supplied antimicrobials by NMS while Doxycycline (10%), Amoxicillin (19%), and Metronidazole (10%) were the most supplied by JMS. The majority of antimicrobials supplied by NMS (81%) and JMS (66%) were from the Access category. Increasing antimicrobial consumption density (DDD per 100 patient days) was observed from national referral to lower-level health facilities. Except for NMS in 2019, total antimicrobials supplied by NMS and JMS remained the same from 2017 to 2019. This serves as a baseline for future assessments and monitoring of stewardship interventions.

42 THE DEFINED DAILY DOSE CAN ASSESS POSTOPERATIVE CHANGE IN ANTIHYPERTENSIVE DRUG CONSUMPTION IN PATIENTS WITH PRIMARY ALDOSTERONISM

2013 ◽  
Vol 189 (4S) ◽  
Author(s):  
Takanobu Utsumi ◽  
Mayuko Kaga ◽  
Tomokazu Sazuka ◽  
Mitsuru Yanagisawa ◽  
Kazuyoshi Nakamura ◽  
...  
Keyword(s):  
Antihypertensive Drug ◽  
Primary Aldosteronism ◽  
Drug Consumption ◽  
Defined Daily Dose ◽  
Postoperative Change ◽  
Daily Dose

Placebo-Controlled Trial of Lithium Augmentation of Fluoxetine and Lofepramine

1995 ◽  
Vol 166 (1) ◽  
pp. 80-86 ◽  
Author(s):  
Cornelius L. E. Katona ◽  
Mohammed T. Abou-Saleh ◽  
Deborah A. Harrison ◽  
Bertrand A. Nairac ◽  
Denzil R. L. Edwards ◽  
...  
Keyword(s):  
Rating Scale ◽  
Antidepressant Treatment ◽  
Controlled Trial ◽  
Depressive Illness ◽  
Controlled Trials ◽  
Major Depressive ◽  
Double Blind ◽  
Primary Care Settings ◽  
Resistant Depression ◽  
Lithium Augmentation

BackgroundThis study was designed to establish whether (as suggested in a number of open and relatively small controlled trials) lithium augmentation is more effective than continued antidepressant alone, where response to a standard course of antidepressant treatment has been absent or partial.MethodLithium or placebo was added on a double-blind basis for six weeks to the drug regime of 62 patients with major depressive illness (in both hospital and primary care settings) who had failed to respond to a controlled trial of fluoxetine or lofepramine. Response was defined as a final Hamilton Depression Rating Scale (HDRS) score of < 10.ResultsResponse was seen more frequently in patients taking lithium (15/29) than in those remaining on antidepressant alone (8/32; P < 0.05). Rapid response to lithium augmentation (LA) was not consistently observed in this cohort. Mean HDRS scores after six weeks were significantly lower (P < 0.01) in the lithium group after excluding those who had not achieved significant exposure to lithium (arbitrarily defined as two or more lithium levels ≥ 0.4 mmol/1). No differences in the efficacy of LA were apparent between fluoxetine and lofepramine.ConclusionsOur results confirm that LA is a useful strategy in the treatment of antidepressant-resistant depression. Partial response was, however, frequently observed with continued antidepressant treatment alone, and the superiority of LA appears to depend on achieving adequate serum lithium levels.

scholarly journals Study on drug utilization pattern and cost analysis among the psychiatric patients treated with various benzodiazepine derivatives

2020 ◽  
Vol 9 (6) ◽  
pp. 975
Author(s):  
Dhivya Govindasamy ◽  
Gandhibabu Ramanathan ◽  
Talari Venkata Siva Prasad ◽  
Gopalakrishnan Ganesan
Keyword(s):  
Cost Analysis ◽  
Drug Utilization ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Psychiatric Patients ◽  
Age Groups ◽  
Alcohol Withdrawal Syndrome ◽  
Defined Daily Dose ◽  
Utilization Pattern ◽  
Daily Dose

Background: The objective of the study was to assess drug utilization pattern and cost analysis among the psychiatric patients treated with various benzodiazepine derivatives.Methods: This observational study was conducted in department of psychiatric, RMMCH, Annamalai University. The study period was 6 months (November 2018 to April 2019). A total of 50 psychiatric patients were included.Results: A total 50 patients among them 64% (32) males and 36% (18) female, were included in the study. Most of the patient were between the age groups of 18-29 years (30%). The most common clinical condition treated with benzodiazepines were alcohol dependence syndrome/alcohol withdrawal syndrome/ alcohol related psychotic disorder (34%). The majority of patients were prescribed with clonazepam (66.67%). The defined daily dose (DDD) per 100 bed days of benzodiazepines were found to be 0.89. In this study the comparison of cost analysis for the drug used and it was found that lorazepam (122%) are most expensive followed by chlordiazepoxide (93.3%) and clonazepam (78.57%). The cheapest drug was nitrazepam (36.84%).Conclusions: The majority of the patient admitted in the psychiatric department were suffering from Alcohol depending syndrome/alcohol withdrawal syndrome. The most commonly prescribed benzodiazepine was clonazepam followed by lorazepam and least prescribed diazepam and nitrazepam based on defined daily dose concept.

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