scholarly journals Prescription of antidepressants to patients on opioid maintenance therapy – a pharmacoepidemiological study

2011 ◽  
Vol 21 (1) ◽  
Author(s):  
Ingeborg Hartz ◽  
Jørgen G. Bramness ◽  
Svetlana Skurtveit
Keyword(s):  
Drug Therapy ◽  
Prescription Drugs ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Antidepressant Drug ◽  
Antidepressant Drugs ◽  
Defined Daily Dose ◽  
Prescription Database ◽  
Depression And Anxiety ◽  
Norwegian Prescription Database ◽  
Antidepressant Use

<p><em><strong>Background and aims</strong></em>: Depression and anxiety are commonly reported among patients in opioid maintenance treatment (OMT). The aim of the present study was to describe aspects of prescription of antidepresant drug therapy among patients on OMT. Our research questions were: 1) What is the prevalence of antidepressant use according to age and gender? 2) Which antidepressants are used? 3) How are antidepressants used in terms of reimbursement codes, dispensed dose and duration of therapy?</p><p><em><strong>Methods</strong></em>: Pharmacoepidemiological data were retrieved from the complete national Norwegian Prescription Database which contains information on all prescription drugs (such as Anatomical Theraputical Chemical (ATC)-code, Defined Daily Dose (DDDs)), dispensed at pharmacies to individual patients. Norwegian OMT-patients (N=4374, 3035 men and 1339 women) who received methadone mixture, buprenorphine capsules or combined buprenorphine-naloxone capsules for at least 6 months in 2009 were included. Prevalence of antidepressant use in the studied patients was measured in terms of retrieval of prescriptions.</p><p><em><strong>Results:</strong></em> During 2009 21.7% of the studied patients filled at least one prescription for an antidepressant drugs (men: 21.2%; women: 22.9%). The subgroup of antidepressants most frequently dispensed was selective serotonin reuptake inhibitors (SSRIs) (33%), followed by the sedative antidepressants mianserin and mirtazapin (22%) and tricyclic antidepressants (TCAs) (20%). Except for TCAs, prescriptions of all antidepressant subgroups were reimbursed for either anxiety or depression in 90% of the cases. Overall, 46.9% of the antidepressant users were prescribed antidepressants in the category &lt; 1 DDD per day and/or treatment &lt; 3 months, with no gender difference.</p><p><em><strong>Conclusions</strong></em>: About one out of five OMT-patients filled a prescription for an antidepressant drug in 2009. Above 90% had their prescriptions reimbursed for either depression or anxiety. Use at low doses and/or sporadic use among half of the antidepressant users may reflect poor compliance or use for other maladies than the reimbursed disease code. Drug therapy for depression and anxiety among OMT-patients seems to be in line with recommendations for use; the SSRIs constitute the recommended drugs of choice due to their better effect/side effect profile, compared to the older antidepressants such as the TCAs.</p>

scholarly journals EPID-36. ANTIDEPRESSANT DRUG USE IN GLIOBLASTOMA PATIENTS: AN EPIDEMIOLOGICAL VIEW

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii86-ii86
Author(s):  
Dorothee Gramatzki ◽  
James Rogers ◽  
Marian Neidert ◽  
Caroline Hertler ◽  
Emilie Le Rhun ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Drug Use ◽  
Survival Data ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Methylation Status ◽  
Antidepressant Drug ◽  
Antidepressant Drugs ◽  
Population Level ◽  
Disease Course

Abstract PURPOSE Antidepressant drugs have shown anti-tumor activity in preclinical glioblastoma studies. Antidepressant drug use, as well as its association with survival, in glioblastoma patients has not been well characterized on a population level. METHODS Patient characteristics, including the frequency of antidepressant drug use, were assessed in a glioblastoma cohort diagnosed in a 10-year time-frame between 2005 and 2014 in the Canton of Zurich, Switzerland. Cox proportional hazards regression models were applied for multivariate analysis. Kaplan-Meier survival curves were used to estimate overall survival data and the log-rank test was performed for comparisons. RESULTS Four hundred four patients with isocitrate dehydrogenase (IDH) wildtype glioblastoma were included in this study. Sixty-five patients (16.1%) took antidepressant drugs at some point during the disease course. Patients were most commonly prescribed selective serotonin reuptake inhibitors at any time (N=46, 70.8%). Nineteen patients (29.2%) were on antidepressant drugs at the time of their tumor diagnosis. No differences were observed in overall survival between those patients who had taken antidepressants at some point in their disease course and those who had not (p=0.356). These data were confirmed in a multivariate analysis including age, Karnofsky performance status, gender, extent of resection, O6-methylguanine DNA methyltransferase (MGMT) promoter methylation status, and first-line treatment as cofounders (p=0.315). Also, there was no association of use of drugs modulating voltage-dependent potassium channels (citalopram; escitalopram) with survival (p=0.639). CONCLUSIONS This signal-seeking study does not support the hypothesis that antidepressants have antitumor efficacy in glioblastoma on a population level.

scholarly journals Increased Use of Antidepressants in Wuhan, China: a Retrospective Study From 2006 to 2012

Medicina ◽  
2014 ◽  
Vol 49 (12) ◽  
pp. 83
Author(s):  
Ping Gao ◽  
Huanian Zhang ◽  
Hua Xu ◽  
Chengliang Zhang ◽  
Dong Liu
Keyword(s):  
Selective Serotonin Reuptake Inhibitors ◽  
Low Cost ◽  
Pharmacoeconomic Evaluation ◽  
World Health ◽  
Selective Serotonin ◽  
Defined Daily Dose ◽  
Cost Advantage ◽  
Daily Cost ◽  
Tetracyclic Antidepressants ◽  
Antidepressant Use

Objective. The aim of this study was to investigate the trend of antidepressant use and analyze the daily cost of antidepressants in Wuhan, China. Material and Methods. The data on the expenditure of antidepressants in Wuhan from 2006 to 2012 were retrospectively analyzed based on the defined daily dose (DDD) method recommended by the World Health Organization. In addition, the daily cost of antidepressants was calculated for the pharmacoeconomic evaluation. Results. The overall sales of antidepressants increased by 566.7% over the 7-year period. The utilization of antidepressants increased annually from 1.067 DDDs per 1000 inhabitants per day in 2006 to 4.144 in 2012. This upward trend was mainly driven by an increase in the use of selective serotonin reuptake inhibitors (SSRIs), which accounted for about 60% of antidepressant use. Notably, the use of traditional Chinese patent medicines (TCMs) approved to treat depression in China in 2010 increased from 0.158 DDDs per 1000 inhabitants per day in 2010 to 0.305 in 2012. The daily drug cost analysis indicated that selective serotonin and norepinephrine reuptake inhibitors (SNRIs) and other new antidepressants were more expensive while tricyclic and tetracyclic antidepressants (TCAs) had a low-cost advantage. Conclusions. Antidepressants were increasingly used over the study period. Among them, SSRIs followed by SNRIs were the most commonly used. After the approval for the treatment of depression, TCMs were generally accepted by physicians and patients. The low-cost advantage allowed TCAs to be used in the antidepressant therapy.

scholarly journals Antidepressant Use and Risk of Suicidal Behavior in Older Persons With Depression: A Cohort Study in Hong Kong

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 441-441
Author(s):  
Yi Chai ◽  
Hao Luo ◽  
Kenneth K C Man ◽  
Wallis C Y Lau ◽  
Ian C K Wong
Keyword(s):  
Hong Kong ◽  
Suicidal Behavior ◽  
Older Persons ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Age Groups ◽  
Antidepressant Drugs ◽  
Age Group ◽  
Self Harm ◽  
Antidepressant Use

Abstract Background Depression is highly prevalent in older adults and requires treatment. However, debate persists on whether antidepressant use is associated with an elevated risk of suicidal behavior. This study aims to examine the short- and long-term risk of suicidal behavior by various classes of antidepressants in older persons with depression. Methods Persons aged 40 years and above and received a clinical diagnosis of depression between January 1, 2001, and December 31, 2016 were identified from the Clinical Data Analysis and Reporting System in Hong Kong. The risk of suicidal behavior in persons who were prescribed antidepressants was compared with persons who were not prescribed any antidepressant drugs. Antidepressants were classified as tricyclic and related antidepressant drugs (TCAs), selective serotonin reuptake inhibitors (SSRIs), noradrenergic and specific serotonergic antidepressants (NaSSAs), serotonin–norepinephrine reuptake inhibitors (SNRIs) and others. Incidence and adjusted hazard ratio (aHR) of subsequent self-harm and suicide within one-year and the whole study period were estimated by age groups. Results A total of 34,927 persons aged 40-64 years, and 19,300 persons aged 65+ years were included. In the younger age group, the highest short-term and long-term risks were found in others (aHR, 2.33; 1.02-5.34) and NaSSAs (2.88; 2.15-3.86), respectively. In the older age group, no significant association was observed between antidepressant use and suicidal behavior across all antidepressant classes. Conclusion The self-harm and suicide associated risks vary across antidepressant classes and age groups. Cautions are always needed for antidepressant prescriptions.

Utilization patterns of antidepressants between 1991 and 2011 in a population-based cohort of middle-aged and elderly

2014 ◽  
Vol 29 (6) ◽  
pp. 365-370 ◽  
Author(s):  
N. Aarts ◽  
R. Noordam ◽  
A. Hofman ◽  
H. Tiemeier ◽  
B.H. Stricker ◽  
...  
Keyword(s):  
Selective Serotonin Reuptake Inhibitors ◽  
Antidepressant Drug ◽  
Population Based ◽  
Ageing Population ◽  
Middle Aged ◽  
Loss To Follow Up ◽  
Patterns Of Use ◽  
Antidepressant Use ◽  
One Year ◽  
Over Time

AbstractBackgroundIn middle-aged and older patients in whom antidepressant use increased in last decades, patterns of use might be of concern The objective of this study was to investigate the patterns of prevalence, incidence and duration of antidepressant use in an ageing population.MethodsAll participants (aged > 45 years) from the population-based Rotterdam Study were followed from January 1st 1991 until death, loss to follow-up, or end of the study period (December 31st 2011). Antidepressant drug dispensing, based on pharmacy records, were subdivided into Tricyclic Antidepressants (TCAs), Selective Serotonin Reuptake Inhibitors (SSRIs) and other antidepressants. One-year prevalence, 5-year incidence and duration of antidepressant use were calculated.ResultsYearly prevalence of antidepressant use increased from 3.9% in 1991 to 8.3% of the population in 2011. The increase in SSRI use was 5.8-fold, whereas use of other antidepressants doubled and TCA use remained stable over time. Incidence of all antidepressants decreased from 23.9 to 14.2 per 1000 person-years between 1992 and 2011. The duration of a first treatment episode increased over time.ConclusionDespite the prevalence of antidepressant use increased over time, incidence did not, which is most likely explained by a longer treatment duration and recurrent episodes.

scholarly journals New classes of antidepressant drugs

1999 ◽  
Vol 5 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Allan I. F. Scott
Keyword(s):  
Reuptake Inhibitor ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Tricyclic Antidepressants ◽  
Antidepressant Drug ◽  
Antidepressant Drugs ◽  
Noradrenaline Reuptake ◽  
Meta Analyses ◽  
Prevention Of Relapse ◽  
Serotonergic Antidepressant ◽  
Noradrenaline Reuptake Inhibitor

The January 1997 issue of this journal contained four reviews that compared tricyclic antidepressants with selective serotonin reuptake inhibitors (SSRIs) and other newer antidepressants in terms of their pharmacology (Palazidou, 1997), adverse effects, potential drug interactions and toxicity (Henry, 1997), efficacy in the prevention of relapse and recurrence (Edwards, 1997), and findings from meta-analyses (Anderson, 1997). In July 1997 reboxetine was promoted as the first selective noradrenaline reuptake inhibitor (NARI), and in October of the same year mirtazapine was promoted as the first noradrenergic and specific serotonergic antidepressant (NaSSA). Milnacipran is presently being registered by the manufacturers, after which it will be the second antidepressant drug promoted as a specific serotonin and noradrenaline reuptake inhibitor (SNRI).

scholarly journals GPs’ drug treatment for depression by patients’ educational level: registry-based study

BJGP Open ◽  
2021 ◽  
pp. BJGPO-2020-0122
Author(s):  
Anneli Borge Hansen ◽  
Valborg Baste ◽  
Oystein Hetlevik ◽  
Inger Haukenes ◽  
Tone Smith-Sivertsen ◽  
...  
Keyword(s):  
General Practice ◽  
Drug Treatment ◽  
Antidepressant Treatment ◽  
Antidepressant Drugs ◽  
Prescription Database ◽  
Highly Educated ◽  
Cox Proportional Hazard ◽  
Norwegian Prescription Database ◽  
To Receive

BackgroundAntidepressant drugs are often prescribed in general practice. Evidence is conflicting on how patient education influences antidepressant treatment.AimTo investigate the association between educational attainment and drug treatment in adult patients with a new depression diagnosis, and to what extent sex and age influence the association.Design & settingA nationwide registry-based cohort study was undertaken in Norway from 2014–2016.MethodThe study comprised all residents of Norway born before 1996 and alive in 2015. Information was obtained on all new depression diagnoses in general practice in 2015 (primary care database) and data on all dispensed depression medication (Norwegian Prescription Database [NorPD]) 12 months after the date of diagnosis. Independent variables were education, sex, and age. Associations with drug treatment were estimated using a Cox proportional hazard model and performed separately for sex.ResultsOut of 49 967 patients with new depression (61.6% women), 15 678 were dispensed drugs (30.4% women, 33.0% men). Highly educated women were less likely to receive medication (hazard ratio [HR] = 0.93; 95% confidence interval [CI] = 0.88 to 0.98) than women with low education. No such differences appeared among men. Women aged 20–29 years were more likely to be treated with drugs than those aged 30–59 years, and women aged ≥70 years were more likely to receive drugs (HR = 1.65; 95% CI = 1.54 to 1.77) than those aged 20–29 years. The pattern was similar but less pronounced for men.ConclusionEducational differences in antidepressant therapy among women may reflect different treatment approaches that clinicians should be aware of to avoid unintended variation. Reasons for this variation and consequences for quality of treatment should be explored.

scholarly journals Increased risk of hip fracture among older people using antidepressant drugs: data from the Norwegian Prescription Database and the Norwegian Hip Fracture Registry

2013 ◽  
Vol 42 (4) ◽  
pp. 514-520 ◽  
Author(s):  
Marit Stordal Bakken ◽  
Anders Engeland ◽  
Lars B. Engesæter ◽  
Anette Hylen Ranhoff ◽  
Steinar Hunskaar ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Older People ◽  
Antidepressant Drugs ◽  
Prescription Database ◽  
Increased Risk ◽  
Norwegian Prescription Database

scholarly journals Maternal depression, antidepressant use in pregnancy and Apgar scores in infants

2013 ◽  
Vol 202 (5) ◽  
pp. 347-351 ◽  
Author(s):  
Hans M⊘rch Jensen ◽  
Randi Gr⊘n ◽  
Øjvind Lidegaard ◽  
Lars Henning Pedersen ◽  
Per Kragh Andersen ◽  
...  
Keyword(s):  
Maternal Depression ◽  
Apgar Score ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Subsequent Pregnancy ◽  
Prescription Database ◽  
Apgar Scores ◽  
Medical Birth Register ◽  
Depression Status ◽  
Central Register ◽  
Antidepressant Use

BackgroundUse of antidepressants during pregnancy has been associated with a low Apgar score in infants but a contribution from the underlying depressive disorder might influence this association.AimsTo estimate the effects of maternal depression and use of antidepressants during pregnancy on low Apgar scores (<7) 5min after birth.MethodRegister study on all pregnant women in Denmark from 1996 to 2006 linking nationwide individualised data from the Medical Birth Register, the Psychiatric Central Register and the National Prescription database.ResultsInfants exposed to antidepressants during pregnancy had an increased rate of a low Apgar score (odds ratio (OR) = 1.72, 95% CI 1.34-2.20). The increased rate was only found among infants exposed to selective serotonin reuptake inhibitors (SSRIS) (OR =1.96, 95% CI 1.52-2.54), not among those exposed to newer (OR = 0.83, 95% CI 0.40-1.74) or older antidepressants (OR=0.53, 95% CI 0.19-1.45). Maternal depression before or during pregnancy, without prescription of antidepressants, was not associated with a low Apgar score (OR=0.44, 95% CI 0.11-1.74). Women who had only used antidepressants prior to pregnancy had no increased rate of a low Apgar score in their subsequent pregnancy, regardless of depression status.ConclusionsUse of SSRls during pregnancy increases the risk of a low Apgar score independently of maternal depression.

scholarly journals Antidepressant Drugs Effects on Blood Pressure

2021 ◽  
Vol 8 ◽  
Author(s):  
Anna Calvi ◽  
Ilaria Fischetti ◽  
Ignazio Verzicco ◽  
Martino Belvederi Murri ◽  
Stamatula Zanetidou ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Orthostatic Hypotension ◽  
Reuptake Inhibitor ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Hypertensive Crisis ◽  
Antidepressant Drug ◽  
Antidepressant Drugs ◽  
Norepinephrine Reuptake Inhibitor ◽  
Norepinephrine Reuptake

Individuals suffering from depressive disorders display a greater incidence of hypertension compared with the general population, despite reports of the association between depression and hypotension. This phenomenon may depend, at least in part, on the use of antidepressant drugs, which may influence blood pressure through different effects on adrenergic and serotoninergic pathways, as well as on histaminergic, dopaminergic, and cholinergic systems. This review summarizes extant literature on the effect of antidepressant drugs on blood pressure. Selective serotonin reuptake inhibitors are characterized by limited effects on autonomic system activity and a lower impact on blood pressure. Thus, they represent the safest class—particularly among elderly and cardiovascular patients. Serotonin–norepinephrine reuptake inhibitors, particularly venlafaxine, carry a greater risk of hypertension, possibly related to greater effects on the sympathetic nervous system. The norepinephrine reuptake inhibitor reboxetine is considered a safe option because of its neutral effects on blood pressure in long-term studies, even if both hypotensive and hypertensive effects are reported. The dopamine–norepinephrine reuptake inhibitor bupropion can lead to blood pressure increases, usually at high doses, but may also cause orthostatic hypotension, especially in patients with cardiovascular diseases. The norepinephrine–serotonin modulators, mirtazapine and mianserin, have minimal effects on blood pressure but may rarely lead to orthostatic hypotension and falls. These adverse effects are also observed with the serotonin-reuptake modulators, nefazodone and trazodone, but seldomly with vortioxetine and vilazodone. Agomelatine, the only melatonergic antidepressant drug, may also have limited effects on blood pressure. Tricyclic antidepressants have been associated with increases in blood pressure, as well as orthostatic hypotension, particularly imipramine. Oral monoamine–oxidase inhibitors, less frequently skin patch formulations, have been associated with orthostatic hypotension or, conversely, with hypertensive crisis due to ingestion of tyramine-containing food (i.e., cheese reaction). Lastly, a hypertensive crisis may complicate antidepressant treatment as a part of the serotonin syndrome, also including neuromuscular, cognitive, and autonomic dysfunctions. Clinicians treating depressive patients should carefully consider their blood pressure status and cardiovascular comorbidities because of the effects of antidepressant drugs on blood pressure profiles and potential interactions with antihypertensive treatments.

scholarly journals Use of Antidepressants among Patients Diagnosed with Depression: A Scoping Review

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Nirmal Raj Marasine ◽  
Sabina Sankhi ◽  
Rajendra Lamichhane ◽  
Nabin Raj Marasini ◽  
Nim Bahadur Dangi
Keyword(s):  
Reuptake Inhibitor ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Antidepressant Drugs ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Tolerability Profile ◽  
Highly Educated ◽  
Treatment Of Depression ◽  
Antidepressant Use

Introduction. Depression is a major global health problem with a relatively high lifetime prevalence and significant disability. Antidepressants are the most effective medications used for the treatment of depression. Hence, this study is aimed at summarizing the studies on antidepressant use among patients diagnosed with depression. Method. PubMed, Embase, Web of Science, Scopus, and Google Scholar were searched for literature (2000-2019) using keywords such as depression, drug utilization, antidepressants, prescription, serotonin reuptake inhibitor, serotonin and norepinephrine reuptake inhibitor, tricyclic antidepressants, and atypical antidepressants. Results. Antidepressant users were mostly females, married people, housewives, lower-income people, employees, and highly educated people, as they were found to be more prone to develop depression than their counterparts. Selective serotonin reuptake inhibitors (SSRIs), such as sertraline, were most commonly prescribed among depressive patients. Conclusion. Our study suggested that out of five major antidepressant drugs available for the treatment of depression, selective serotonin reuptake inhibitors are preferred over others because of their better side effects and tolerability profile.

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